Single‐center review on safety of biodegradable airway stenting in pediatric population

Minen, Federico; Durward, Andrew; James, Paul; Diamantopoulos, Athanasios; Jogeesvaran, Haran; Morgan, Gareth J.; Nyman, Andrew

doi:10.1002/ppul.26670

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…Albeit most patients with TM or BM may outgrow their disease, a distinct group may exhibit life-threatening symptoms such as apnoeic spells or inability to extubate the airway. In this settingt, surgical or endoscopical treatment is mandatory (10).…”

Section: Discussionmentioning

confidence: 99%

“…Most of these patients exhibit severe associated anomalies, mainly cardiovascular and syndromic, that have a relevant impact in their clinical status so it is sometimes difficult to establish the precise contribution of airway malacia to the clinical situation. The rationale for using BD stents in this particular scenario relies on what is called the "proof of principle " (10). This means that restoration of patency improves clinical status before attempting surgery or permament stenting.…”

Section: Discussionmentioning

confidence: 99%

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Further experience with polydioxanone airway stents in children.

Anton-Pacheco,

Morante,

Díaz

et al. 2024

Preprint

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Introduction The aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children focusing on effectiveness and safety, and to analyse the factors involved in the different outcomes observed. Materials and methods Retrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication , clinical baseline, stent size, location, complications, clinical outcome, and time of follow-up. Statistical analyses were performed in order to detect the eventual contribution of variables in the different outcomes observed. Results 54 PDO stents were placed in 26 patients (median age, 4 m). All showed severe symptoms of central airway obstruction due to: tracheomalacia 9 patients, bronchomalacia 5, tracheobronchomalacia 10, and tracheal stenosis 2. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in main bronchi. 53,8% of patients needed successive stenting and all exhibited comorbidities. Complete clinical resolution was observed in 8 cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsen in one. Age had a significant positive impact in outcome (6 months vs 3 m.; p=0.024). Additionally, smaller stents were associated with a better outcome (20 vs 26 mm; p=0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow-up was complete in survivors (median, 58 m). Conclusions PDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent-related granulation tissue continues to be a relevant matter of concern. This issue together with increased degradation times deserve further research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Further experience with polydioxanone airway stents in children.

Anton-Pacheco,

Morante,

Díaz

et al. 2024

Preprint

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“…A recent study by Minen et al investigated PDO stents for 33 pediatric patients with severe airway issues, yielding promising outcomes and minimal adverse effects [42]. A systematic review explored bioresorbable intraluminal stents for pediatric tracheobronchial obstructions using materials like PDO and PLLA.…”

Section: Stent Materialsmentioning

confidence: 99%

Advancements in airway stents: a comprehensive update

Aravena,

Gildea

2023

Current Opinion in Pulmonary Medicine

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Purpose of review This review provides an overview of the evolving field of airway stenting (AS), highlighting its relevance in the management of central airway obstruction (CAO). It discusses recent advancements, including 3D-printed silicone stents (3DPSS), metallic stents, biodegradable stents (BS), and drug-eluting stents (DES), which are transforming clinical practice. The review underscores the ongoing challenges in patient selection, stent choice, and long-term management in the context of an evolving landscape. Recent findings Innovations, particularly 3DPSS, have shown promise in providing patient-specific solutions. These stents offer improved symptom relief, enhanced quality of life, and lower complication rates, especially for complex airway diseases. The use of BS and DES is explored, raising prospects for future applications. Summary The evolution of AS reflects a deepening understanding of airway obstructions. Recent innovations, such as 3DPSS, BS, and DES, show considerable promise in addressing the limitations of conventional stents. However, challenges related to complications, patient selection, and long-term management persist, demanding further research. Wide practice variations in the management of AS highlight the need for more clinical data and standardized guidelines. The search for the ideal stent continues, driven by the pursuit of better outcomes for patients with CAO.

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Further experience with polydioxanone airway stents in children

Morante‐Valverde,

Díaz,

Luna‐Paredes

et al. 2024

Pediatric Pulmonology

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IntroductionThe aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children, focusing on effectiveness and safety, and to analyze the factors involved in the different outcomes observed.Materials and MethodsRetrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication, clinical baseline, stent size, location, complications, clinical outcome, and time of follow‐up. Statistical analyses were performed to detect the eventual contribution of variables in the different outcomes observed.ResultsFifty‐four PDO stents were placed in 26 patients (median age, 4 months). All showed severe symptoms of central airway obstruction due to tracheomalacia in nine patients, bronchomalacia five, tracheobronchomalacia 10, and tracheal stenosis two. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in the main bronchi. 53.8% of patients needed successive stenting, and all exhibited comorbidities. Complete clinical resolution was observed in eight cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsened in one. Age had a significant positive impact on outcome (6 vs. 3 months; p = 0.024). Additionally, smaller stents were associated with a better outcome (20 vs. 26 mm; p = 0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow‐up was complete in survivors (median, 58 months).ConclusionsPDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent‐related granulation tissue continues to be a relevant matter of concern. This issue, together with increased degradation times, deserves further research.

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Single‐center review on safety of biodegradable airway stenting in pediatric population

Cited by 6 publications

References 27 publications

Further experience with polydioxanone airway stents in children.

Further experience with polydioxanone airway stents in children.

Advancements in airway stents: a comprehensive update

Further experience with polydioxanone airway stents in children

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