Use of Nitinol Stents for End‐Stage Tracheal Collapse in Dogs

Abstract

Use of a nitinol stent (Vet Stent-Trachea®) in dogs with end-stage tracheal collapse is associated with a fair to good outcome despite significant temporal stent fore shortening after bronchoscopic placement.

Use of a double-wire woven uncovered nitinol stent for the treatment of refractory tracheal collapse in a dog: a case report

“…In a retrospective study, 10 of 12 (83%) dogs that underwent placement of self-expanding nitinol intratracheal stents survived longer than one year and among them seven dogs survived longer than two years (Sura and Krahwinkel 2008). Another report by Durant et al (2012) reported that seven of 18 (39%) and five dogs with tracheal collapse were still alive one year and two years after nitinol intratracheal stent placement, respectively.…”

“…However, these stent fractures could be caused by persistent coughing attributable to progressive bronchial collapse and irritation secondary to stent design. In fact, recent evaluation of longterm outcome following nitinol stent placement in dogs with tracheal collapse revealed favourable results (Sura and Krahwinkel 2008;Durant et al 2012). In a retrospective study, 10 of 12 (83%) dogs that underwent placement of self-expanding nitinol intratracheal stents survived longer than one year and among them seven dogs survived longer than two years (Sura and Krahwinkel 2008).…”

“…Because tracheal collapse is a dynamic process, tracheoscopy is to be preferred over standard lateral thoracic radiographs, as it can allow correct determination of the degree of tracheal collapse and can adequately determine maximal tracheal diameter to ensure the proper size of a stent (Tangner and Hobson 1982;Sura and Krahwinkel 2008). Recently, endoscopic-assisted tracheal stent placement has been reported as an additional method that could contribute to decreasing surgeon error as it allows direct observation of the caudal aspect of the stent during deployment, decreased exposure to ionising radiation, and decreased operative time (Durant et al 2012). However, this measurement requires specialised equipment and computer programs to calculate relevant tracheal dimensions (Gellasch et al 2002;Maetani et al 2007).…”

“…The implantation of self-expandable metallic stents appears to be especially promising for intraluminal stabilisation of collapsed trachea in that it can facilitate an immediate improvement of clinical signs, requires only short anaesthetic time, is minimally invasive and allows access to the entire trachea (Beal 2013). Uncovered nitinol wire mesh stents with single-wire woven structures are increasingly being used for the management of dogs with end stage tracheal collapse (Gellasch et al 2002;Durant et al 2012;Tinga et al 2015). However, despite the major advantages of endotracheal stenting, severe complications including stent fracture have been described (Mittleman et al 2004;Woo et al 2007).…”

“…Collapsed trachea initiates 'honking' cough, which can lead to life-threatening conditions including severe respiratory distress, cyanosis, and syncope (Fossum 2007;Durant et al 2012). Treatments usually include medical therapy that can be considered as the first option in patients with mild clinical signs, and surgical therapy that can be employed for patients with unsatisfactory response to medical therapy (Kim et al 2008;Sura and Krahwinkel 2008;Beal 2013).…”