Chest
Clinical Investigations: BronchoscopyRemoval of Covered Self-Expandable Metallic Airway Stents in Benign Disorders: Indications, Technique, and Outcomes
Section snippets
Materials and Methods
We retrospectively analyzed data on all patients with benign disorders who received SEMAS between 1997 and 2003. Data were extracted from electronic files of our institution archive.
Forty-nine SEMAS (41 covered Ultraflex stents, 6 uncovered Ultraflex stents, and 2 Wallstents) were inserted by rigid bronchoscopy in the central airways of 39 patients hospitalized for benign airway disorders in our institution. There were 24 male and 15 female patients (mean age, 59 ± 16 years [± SD]; range, 16 to
Results
Ten of the 39 patients (25.6%), all of them bearing covered versions of SEMAS, presented with an indication for stent removal during the follow-up period (5 male and 5 female patients; mean age, 48 ± 15 years; range, 16 to 62 years). Indications for removal included restenosis due to excessive or recurrent granuloma formation impossible to manage with other treatment modalities (five cases), relapse of stenosis after initial treatment due to material fatigue (one case), stent fracture (two
Discussion
The management of patients with tracheobronchial strictures of benign etiology can be quite challenging. There are a large number of patients with lesions not amenable to surgery, or who are considered medically inoperable.2 In these patients, airway stenting may represent the only possible treatment. Silicone prostheses are considered the first choice in benign diseases except in cases where they are judged unsuitable because of airway wall malacia or distal and/or angular stenosis. In such
Conclusion
Although placement of SEMAS is assumed to be permanent in patients with benign airway disorders, an indication for stent removal is often observed (25.6% in our series). The results obtained in our study suggest that covered SEMAS can be both effectively and safely removed if needed without major sequelae. However, removal can be cumbersome in inexperienced hands. Efforts are ongoing to produce better-designed, technically improved, removable airway stents that may be more suitable for
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How risky is it to remove an airway stent?
2023, Respiratory MedicineBiomechanical and functional comparison of moulded and 3D printed medical silicones
2021, Journal of the Mechanical Behavior of Biomedical MaterialsCitation Excerpt :In the present work silicone polymers, intended for otorhinolaryngology applications, namely for respiratory tract stenting, have been characterised for their biomechanical, surface (micro and nanoscale) and protein adsorption properties together with their cytotoxicity. Whereas there are about 100 models of stents known, the problem of tissue granulation, implant stability and operability has not been solved yet (Trabelsi et al., 2011; Noppen et al., 2005). It was previously observed that the biomechanical mismatches between the silicone implants and the surrounding mucosa were inducing serious adverse effects including granuloma formation, local necrosis and chronic inflammation induced restenosis (Nesek-Adam et al., 2010; Alshammari and Monnier, 2012; Ashfaque and Annju, 2018).
Y-shaped airway self-expanding covered metallic stent removal via the interventional technique
2021, Clinical RadiologyFluoroscopy-guided removal of individualised airway-covered stents for airway fistulas
2018, Clinical RadiologyCitation Excerpt :Stent removal is the most reasonable solution under this circumstance.20 At present, the removal of an airway stent is commonly performed at bronchoscopy for the treatment of airway stenosis, which often requires general anaesthesia or endotracheal intubation.14,21–24 In a few cases, the metal stent has been removed by bronchoscopy under local anaesthesia.25,26
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