First Experience With Biodegradable Airway Stents in Children

Vondrys, David; Elliott, Martin J.; McLaren, Clare A.; Noctor, Clair; Roebuck, Derek J.

doi:10.1016/j.athoracsur.2011.07.042

Cited by 112 publications

(75 citation statements)

References 10 publications

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“…In all the cases, stents where made of PDS. Endoscopic placement of these self-expandable stents seemed safe and user friendly in pediatric patients but failed to maintain airway patency in 2 patients [69] requiring their immediate removal. In the 12 remaining patients, the stents relieved the airway narrowing in the short-term but recurrences occurred in all the cases after stent degradation after 4-5 months of initial stenting.…”

Section: Discussionmentioning

confidence: 99%

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Biodegradable Airway Stents - Bench to Bedside: A Comprehensive Review

Dutau¹,

Musani

Laroumagne³

et al. 2015

Respiration

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Airway stents are indicated to treat symptomatic narrowing or to close fistulas of the central airways. They are generally divided into two types: the silicone stents and the metallic stents. Unlike in malignancies, removability is a major objective of temporary stenting in benign conditions, which poses the challenge of a new rigid bronchoscopic procedure under general anesthesia and stent removal with all its attendant risks and costs. The concept of a biodegradable (BD) stent that could maintain the patency of an airway for a predetermined duration of time is very appealing. These BD stents would gradually degrade and eventually vanish from the airway once they are no longer needed. Such stents are currently an area of intense research. Another very promising concept of drug delivery with such stents is also a very exciting area of current research. The aim of this comprehensive review is to discuss all pertinent available literature on the use of BD materials in various clinical applications and to extensively review all animal and humans trials involving BD airway stents.

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Section: Discussionmentioning

confidence: 99%

“…Vondrys et al [69] reported their experience with BD PDS stents for tracheal narrowing in children. Eleven custom-made PDS stents were implanted in 4 patients with airway narrowing due to external compression or intrinsic collapse.…”

Section: Airway Stenting With Degradable Biomaterialsmentioning

confidence: 99%

Biodegradable Airway Stents - Bench to Bedside: A Comprehensive Review

Dutau¹,

Musani

Laroumagne³

et al. 2015

Respiration

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“…5 Después de varios estudios en animales, se comenzaron a utilizar recientemente para el tratamiento de la obstrucción respiratoria en adultos y niños. 5,[8][9][10][11][12] El PDS en un polímero semicristalino biodegradable perteneciente a la familia del poliéster. 1 Se confecciona a medida y se inserta en la vía aérea con broncoscopía rígida bajo anestesia general y con control fluoroscópico.…”

Section: Figura 3 a Tomografía Computada Mediciones Del Bronquio Funclassified

“…Se disuelve por completo hacia la semana 15, por lo que no es necesaria su remoción y permite el crecimiento subsiguiente de la vía aérea. 1,2,4,5,11 Después de la semana 15, no hay residuos de fibra en el epitelio ni en la lámina propia. La cantidad de granulación disminuye y solo se evidencia tejido cicatricial mínimo e infiltración linfoplasmocitaria residual.…”

Section: Figura 3 a Tomografía Computada Mediciones Del Bronquio Funclassified

Stent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

Cuestas

Rodríguez

Doormann

et al. 2018

Arch Argent Pediatr

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Presentación de casos clínicos RESUMENLa obstrucción bronquial es infrecuente en el niño. La causa principal es la malacia o la estenosis de naturaleza benigna. Las alternativas de manejo varían desde el tratamiento conservador hasta complejas técnicas quirúrgicas y/o endoscópicas. La colocación de una endoprótesis (estent) puede desempeñar un papel fundamental en situaciones particulares en las que no hay otra opción terapéutica. Sin embargo, el estent ideal aún no está disponible. En los últimos años, se han comenzado a investigar las propiedades de diversos materiales biodegradables a fin de superar los inconvenientes de los estents tradicionales confeccionados de silicona o metal. Se presenta nuestra experiencia con un nuevo tipo de estent de vía aérea biodegradable en el tratamiento de la broncomalacia grave en un niño de 2 años; se evalúa su seguridad y eficacia clínica. Se describen las indicaciones y las potenciales complicaciones del uso de endoprótesis en la vía aérea en pediatría. Palabras clave: estents, vía aérea, implantes biodegradables, constricción bronquial, niño. ABSTRACTBronchial obstruction is infrequent in the child. The main cause is malacia or benign stenosis. Management alternatives range from conservative treatment to complex surgical and/ or endoscopic techniques. Placement of a stent can play a key role in situations where there is no other therapeutic option. However, the ideal stent is not yet available. In the last few years, progress has been made in the development and characterization of novel biodegradable materials in order to overcome the drawbacks of traditional stents made of silicone or metal. Estent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

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“…These have been used for treatment of obstruction since the 1990s, and can be inserted easily and safely and left in place for prolonged periods to relieve major airway obstruction (32), and have allowed the patient to be managed without mechanical ventilation. Stents have evolved from fixed shapes and sizes to balloon expandable stents originally used for angioplasty, and the stent materials used have changed from metallic to silastic to biodegradable material (33–35). Granulation tissue formation occurs and may require bronchoscopic manipulation with balloon dilatation and early stent removal.…”

Section: Managementmentioning

confidence: 99%

Airway Problems in Neonates—A Review of the Current Investigation and Management Strategies

Mok

2017

Front. Pediatr.

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Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal “communication” in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy. Further imaging techniques help to delineate other commonly associated abnormalities. Echocardiography is also important to confirm any associated cardiac abnormality. In this review, the merits and disadvantages of the various investigations now available to the clinician will be discussed. The current therapeutic strategies are discussed, and the review will focus on the most challenging conditions that cause the biggest management conundrums, specifically laryngotracheal cleft, congenital tracheal stenosis, and tracheobronchomalacia. Management of acquired stenosis secondary to airway injury from endotracheal intubation will also be discussed as this is a common problem. Slide tracheoplasty is the preferred surgical option for long-segment tracheal stenosis, and results have improved significantly. Stents are occasionally required for residual or recurrent stenosis following surgical repair. There is sufficient evidence that a multidisciplinary team approach for managing complex airway issues provides the best results for the patient. There is ongoing progress in the field with newer diagnostic tools as well as development of innovative management techniques, such as biodegradable stents and stem cell-based tracheal transplants, leading to a much better prognosis for these children in the future.

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First Experience With Biodegradable Airway Stents in Children

Cited by 112 publications

References 10 publications

Biodegradable Airway Stents - Bench to Bedside: A Comprehensive Review

Biodegradable Airway Stents - Bench to Bedside: A Comprehensive Review

Stent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

Airway Problems in Neonates—A Review of the Current Investigation and Management Strategies

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