Do airway metallic stents for benign lesions confer too costly a benefit?

Chan, Andrew; Juarez, Maya; Allen, Roblee P.; Albertson, Timothy E

doi:10.1186/1471-2466-8-7

Cited by 32 publications

(17 citation statements)

References 28 publications

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“…USEMAS removal was uneventful, and there was no significant granulation tissue formation compared to higher rates reported in other studies [33,34]. This is due to the fact that stents were placed for a short time before neo-epithelialization occured.…”

Section: Discussionmentioning

confidence: 39%

“…Another study by Chan et al [34] showed a higher long-term complication rate in patients who had metallic stent for benign airway disease, but 90% of stents were removed uneventfully. Thus, it is important to emphasize that when metallic stents are left for a prolonged period of time, they are harder to remove and are associated with increased complications [33,34]. …”

Section: Discussionmentioning

confidence: 99%

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Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse

Majid

Alape²,

Kheir³

et al. 2016

Respiration

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Background: Patients with severe symptomatic expiratory central airway collapse (ECAC) undergo a stent trial to determine whether they are candidate for tracheobronchoplasty. Most stent trials were done using silicone stents. However, there was a higher number of silicone stent-related complications. Objectives: The aim of this study was to evaluate the safety and efficacy of short-term uncovered self-expanding metallic airway stents (USEMAS) in patients with ECAC. Methods: This was a retrospective review. Baseline measurements were compared to those obtained after 7-14 days. Measurements included: Modified Medical Research Council (mMRC), Cough Quality of Life Questionnaire (CQLQ), spirometry testing, and 6-Minute Walk Test (6MWT). Stent- and procedure-related complications were reported. Results: 33 patients (median age, 52 years) underwent the USEMAS trial. Presenting symptoms were dyspnea in 100%, intractable cough in 90.3%, recurrent infection in 42.2%, and inability to clear secretions in 21.4%. Dyspnea, cough, and secretion clearance improved in 88, 70, and 57%, respectively. Overall, there was a significant improvement in mMRC (p < 0.001), CQLQ (p = 0.015), and 6MWT (p = 0.015). There was 1 airway infection, 1 stent migration, and 1 pneumothorax. The median duration of USEMAS was 7 days. All stents were removed without any complications. At the time of stent removal, no granulation tissue was observed in 30.9%, and mild granulation tissue was observed in 69.1%. Conclusion: The short-term USEMAS trial improves respiratory symptoms, quality of life, and exercise capacity with few complications in patients with severe symptomatic ECAC when performed by a multidisciplinary airway team in highly specialized centers with experience in the evaluation and treatment of this patient population.

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Section: Discussionmentioning

confidence: 39%

Section: Discussionmentioning

confidence: 99%

Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse

Majid

Alape²,

Kheir³

et al. 2016

Respiration

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“…In a series of 40 patients this improvement was evident in stridor in 73% of cases, breathlessness in 71%, cough in 79% and in sputum clearance in 75% 91. In five series where a proportion of patients had lung function assessed before and after stent insertion,89 91–94 FEV 1 , forced vital capacity (FVC) and airway resistance (where measured) improved.…”

Section: Therapeutic Procedures For Malignant Disease: Malignant Airwmentioning

confidence: 96%

British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults

Rand

Barber²,

Goldring³

et al. 2011

Thorax

179

180

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“…In De Gregorio et al study, three out of four steel stents that were used to treat benign lesions in the trachea had to be removed a year after their deployment 18 . We have corroborated these findings in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Steel stents were first used in the tracheobronchial tree with initially favorable results, but quickly revealed shortcomings 3,17,18 . In De Gregorio et al study, three out of four steel stents that were used to treat benign lesions in the trachea had to be removed a year after their deployment 18 .…”

Section: Discussionmentioning

confidence: 99%

Tracheal Self-Expandable Metallic Stents: A Comparative Study of Three Different Stents in a Rabbit Model

Serrano

Lostalé

Rodríguez-Panadero

et al. 2016

Archivos de Bronconeumología (English Edition)

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Do airway metallic stents for benign lesions confer too costly a benefit?

Abstract: Background: The use of self-expanding metallic stents (SEMAS) in the treatment benign airway obstruction is controversial.

Cited by 32 publications

References 28 publications

Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse

Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse

British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults

Tracheal Self-Expandable Metallic Stents: A Comparative Study of Three Different Stents in a Rabbit Model

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