Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
Current Pulmonology Reports
Erschienen in:

15.01.2024 | REVIEW

Advances in Airway Stenting

verfasst von: Hatoon Abbas, Faria Nasim

Erschienen in: Current Pulmonology Reports | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

In this review, we summarize the evolution of airway stents through the decades and address the various existing stent types along with some investigational stents, and the available data supporting their use. We also briefly discuss the most common complications, the process of removal, and controversies regarding follow-up.

Recent Findings

Stent technology continues to evolve in an ongoing effort to develop better stents with easier placement or removal, sustained clinical benefit, and the least number of complications. These improvements have allowed for the expansion of stent use from primarily palliation in malignant airway diseases to viable therapies for benign conditions including malacia, fistulas, and post-intubation tracheal stenosis.

Summary

Airway stents can provide prompt and sustained relief of symptoms for a variety of tracheobronchial diseases. Airway stents have undergone significant advancements in the past three decades, starting with single material stents to hybrid stents and now towards more personalized stents.
Literatur
1.
Bolliger CT, Mathur PN, Beamis JF, Becker HD, Cavaliere S, Colt H, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J. 2002;19(2):356–73.
2.
3.
Alraiyes AH, Avasarala SK, Machuzak MS, Gildea TR. 3D printing for airway disease. AME Med J. 2019;4.
4.
Freitag L, Gördes M, Zarogoulidis P, Darwiche K, Franzen D, Funke F, et al. Towards individualized tracheobronchial stents: technical, practical and legal considerations. Respiration. 2017;94(5):442–56.PubMedCrossRef
5.
Xu J, Ong HX, Traini D, Byrom M, Williamson J, Young PM. The utility of 3D-printed airway stents to improve treatment strategies for central airway obstructions. Drug Dev Ind Pharm. 2019;45(1):1–10.PubMedCrossRef
6.
Liu L, Kong J, Georg C. Recent advances in airway stenting. Shanghai Chest. 2020;4:6–6.CrossRef
7.
Cheng GZ, Folch E, Wilson A, Brik R, Garcia N, Estepar RSJ, et al. 3D Printing and Personalized Airway Stents. Pulm Ther. 2017;3(1):59–66.CrossRef
8.
9.
Guibert N, Mhanna L, Didier A, Moreno B, Leyx P, Plat G, et al. Integration of 3D printing and additive manufacturing in the interventional pulmonologist’s toolbox. Respir Med. 2018;134:139–42.PubMedCrossRef
10.
Jung HS, Chae G, Kim JH, Park CY, Lim S, Park SE, et al. The mechanical characteristics and performance evaluation of a newly developed silicone airway stent (GINA stent). Sci Rep. 2021;11(1):7958.PubMedPubMedCentralCrossRefADS
11.
Guibert N, Saka H, Dutau H. Airway stenting: Technological advancements and its role in interventional pulmonology. Respirology. 2020;25(9):953–62.PubMedCrossRef
12.
Ernst A, Majid A, Feller-Kopman D, Guerrero J, Boiselle P, Loring SH, et al. Airway stabilization with silicone stents for treating adult tracheobronchomalacia: a prospective observational study. Chest. 2007;132(2):609–16.PubMedCrossRef
13.
Ozgul MA, Cetinkaya E, Cortuk M, Iliaz S, Tanriverdi E, Gul S, et al. Our experience on silicone Y-stent for severe COPD complicated with expiratory central airway collapse. J Bronchology Interv Pulmonol. 2017;24(2):104–9.PubMedCrossRef
14.
Jiang JH, Zeng DX, Wang CG, Chen YB, Shen D, Mao JY, et al. A pilot study of a novel through-the-scope self-expandable metallic airway stents delivery system in malignant central airway obstruction. Can Respir J. 2019;2019:7828526.PubMedPubMedCentralCrossRef
15.
• Zeng DX, Cheng ZZ, Lv XD, Chen CS, Wang JW, Browning R, et al. Comparison of operation time, efficacy and safety between through-the-scope stent and over-the-while stent in malignant central airway obstruction: a multi-center randomized control trial. Transl Lung Cancer Res. 2022;11(8):1692–701. This is a randomized controlled trial evaluating the efficacy and safety on TTS stents system.
16.
Lund ME, Force S. Airway stenting for patients with benign airway disease and the Food and Drug Administration advisory: a call for restraint. Chest. 2007;132(4):1107–8.PubMedCrossRef
17.
Xiong XF, Xu L, Fan LL, Cheng DY, Zheng BX. Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study. BMC Pulm Med. 2019;19(1):33.PubMedPubMedCentralCrossRef
18.
Abdel-Rahman N, Kramer MR, Saute M, Raviv Y, Fruchter O. Metallic stents for airway complications after lung transplantation: long-term follow-up. Eur J Cardiothorac Surg. 2014;45(5):854–8.PubMedCrossRef
19.
Gottlieb J, Fuehner T, Dierich M, Wiesner O, Simon AR, Welte T. Are metallic stents really safe? A long-term analysis in lung transplant recipients. Eur Respir J. 2009;34(6):1417–22.PubMedCrossRef
20.
Fortin M, Lacasse Y, Elharrar X, Tazi-Mezalek R, Laroumagne S, Guinde J, et al. Safety and efficacy of a fully covered self-expandable metallic stent in benign airway stenosis. Respiration. 2017;93(6):430–5.PubMedCrossRef
21.
Avasarala SK, Sethi S, Machuzak M, Almeida FA, Gildea TR. A single-center case series describing tracheobronchial bonastent implantation. J Bronchology Interv Pulmonol. 2019;26(4):265–72.PubMedCrossRef
22.
Ishida A, Oki M, Saka H. Fully covered self-expandable metallic stents for malignant airway disorders. Respir Investig. 2019;57(1):49–53.PubMedCrossRef
23.
Gildea TR, Downie G, Eapen G, Herth F, Jantz M, Freitag L. A Prospective multicenter trial of a self-expanding hybrid stent in malignant airway obstruction. Journal of Bronchology. 2008;15(4):221–4.CrossRef
24.
Ost DE, Shah AM, Lei X, Godoy MCB, Jimenez CA, Eapen GA, et al. Respiratory infections increase the risk of granulation tissue formation following airway stenting in patients with malignant airway obstruction. Chest. 2012;141(6):1473–81.PubMedCrossRef
25.
Schweiger T, Gildea TR, Prosch H, Lang G, Klepetko W, Hoetzenecker K. Patient-specific, 3-dimensionally engineered silicone Y-stents in tracheobronchomalacia: Clinical experience with a novel type of airway stent. J Thorac Cardiovasc Surg. 2018;156(5):2019–21.PubMedCrossRef
26.
Guibert N, Didier A, Moreno B, Mhanna L, Brouchet L, Plat G, et al. Treatment of post-transplant complex airway stenosis with a three-dimensional, computer-assisted customized airway stent. Am J Respir Crit Care Med. 2017;195(7):e31–3.PubMedCrossRef
27.
Miyazaki T, Yamasaki N, Tsuchiya T, Matsumoto K, Takagi K, Nagayasu T. Airway stent insertion simulated with a three-dimensional printed airway model. Ann Thorac Surg. 2015;99(1):e21–3.PubMedCrossRef
28.
Shan Q, Huang W, Shang M, Wang Z, Xia N, Xue Q, et al. Treatment of aerodigestive fistulas with a novel covered metallic Y-shaped segmented airway stent customized with the assistance of 3D printing. Ann Transl Med. 2021;9(13):1051.PubMedPubMedCentralCrossRef
29.
Shan Q, Huang W, Shang M, Wang Z, Xia N, Xue Q, et al. Customization of stent design for treating malignant airway stenosis with the aid of three-dimensional printing. Quant Imaging Med Surg. 2021;11(4):1437–46.PubMedPubMedCentralCrossRef
30.
Hohenforst-Schmidt W, Zarogoulidis P, Pitsiou G, Linsmeier B, Tsavlis D, Kioumis I, et al. Drug eluting stents for malignant airway obstruction: a critical review of the literature. J Cancer. 2016;7(4):377–90.PubMedPubMedCentralCrossRef
31.
Wang T, Zhang J, Wang J, Pei YH, Qiu XJ, Wang YL. Paclitaxel drug-eluting tracheal stent could reduce granulation tissue formation in a canine model. Chin Med J (Engl). 2016;129(22):2708–13.PubMedCrossRef
32.
Chao YK, Liu KS, Wang YC, Huang YL, Liu SJ. Biodegradable cisplatin-eluting tracheal stent for malignant airway obstruction: in vivo and in vitro studies. Chest. 2013;144(1):193–9.PubMedCrossRef
33.
Zhu GH, Ng AHC, Venkatraman SS, Boey FYC, Wee ALY, Trasti SL, et al. A novel bioabsorbable drug-eluting tracheal stent. Laryngoscope. 2011;121(10):2234–9.PubMedCrossRef
34.
Sigler M, Klötzer J, Quentin T, Paul T, Möller O. Stent implantation into the tracheo-bronchial system in rabbits: histopathologic sequelae in bare metal vs. drug-eluting stents. Mol Cell Pediatr. 2015;2(1):10.
35.
Duvvuri M, Motz K, Tsai HW, Lina I, Ding D, Lee A, et al. Design of a biocompatible drug-eluting tracheal stent in mice with laryngotracheal stenosis. J Vis Exp. 2020;(155).
36.
Stehlik L, Hytych V, Letackova J, Kubena P, Vasakova M. Biodegradable polydioxanone stents in the treatment of adult patients with tracheal narrowing. BMC Pulm Med. 2015;21(15):164.CrossRef
37.
Fernandez-Bussy S, Labarca G, Majid A. Biodegradable stent for vanishing bronchus syndrome after lung transplantation. J Heart Lung Transplant. 2016;35(11):1378–9.PubMedCrossRef
38.
Lischke R, Pozniak J, Vondrys D, Elliott MJ. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg. 2011;40(3):619–24.PubMed
39.
Martinod E, Chouahnia K, Radu DM, Joudiou P, Uzunhan Y, Bensidhoum M, et al. Feasibility of bioengineered tracheal and bronchial reconstruction using stented aortic matrices. JAMA. 2018;319(21):2212–22.PubMedPubMedCentralCrossRef
40.
41.
Inchingolo R, Sabharwal T, Spiliopoulos S, Krokidis M, Dourado R, Ahmed I, et al. Tracheobronchial stenting for malignant airway disease: long-term outcomes from a single-center study. Am J Hosp Palliat Care. 2013;30(7):683–9.PubMedCrossRef
42.
Chung FT, Chen HC, Chou CL, Yu CT, Kuo CH, Kuo HP, et al. An outcome analysis of self-expandable metallic stents in central airway obstruction: a cohort study. J Cardiothorac Surg. 2011;8(6):46.CrossRef
43.
CosanoPovedano A, Muñoz Cabrera L, CosanoPovedano FJ, Rubio Sánchez J, PascualMartínez N, Escribano DA. Endoscopic treatment of central airway stenosis: five years’ experience. Arch Bronconeumol. 2005;41(6):322–7.CrossRef
44.
Gaissert HA, Grillo HC, Wright CD, Donahue DM, Wain JC, Mathisen DJ. Complication of benign tracheobronchial strictures by self-expanding metal stents. J Thorac Cardiovasc Surg. 2003;126(3):744–7.PubMedCrossRef
45.
Lee HJ, Labaki W, Yu DH, Salwen B, Gilbert C, Schneider ALC, et al. Airway stent complications: the role of follow-up bronchoscopy as a surveillance method. J Thorac Dis. 2017;9(11):4651–9.PubMedPubMedCentralCrossRef
46.
Ferretti GR, Kocier M, Calaque O, Arbib F, Righini C, Coulomb M, et al. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy. Eur Radiol. 2003;13(5):1172–8.PubMedCrossRef
47.
•• Mathew R, Hibare K, Dalar L, Roy WE. Tracheobronchial stent sizing and deployment practices airway stenting practices around the world: a survey study. J Thorac Dis. 2020;12(10):5495–504. This study reports the current practice patterns of stent usage.
48.
Bi Y, Yu Z, Ren J, Han X, Wu G. Metallic stent insertion and removal for post-tracheotomy and post-intubation tracheal stenosis. Radiol Med. 2019;124(3):191–8.PubMedCrossRef
49.
Alazemi S, Lunn W, Majid A, Berkowitz D, Michaud G, Feller-Kopman D, et al. Outcomes, health-care resources use, and costs of endoscopic removal of metallic airway stents. Chest. 2010;138(2):350–6.PubMedCrossRef
50.
Shah SK, Jennings JH, Diaz-Mendoza JI, Yessayan L, Ray C, Simoff MJ. Removal of self-expanding metallic stents. J Bronchology Interv Pulmonol. 2016;23(4):279–82.PubMedCrossRef
Metadaten
Titel
Advances in Airway Stenting
verfasst von
Hatoon Abbas
Faria Nasim
Publikationsdatum
15.01.2024
Verlag
Springer US
Erschienen in
Current Pulmonology Reports / Ausgabe 1/2024
Elektronische ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-023-00335-8

Weitere Artikel der Ausgabe 1/2024

Artificial Intelligence in Chest Radiology: Advancements and Applications for Improved Global Health Outcomes

  • REVIEW

Guided Bronchoscopy for Peripheral Pulmonary Lesion Sampling: The Pros and Cons of Electromagnetic Navigation Bronchoscopy and Robotic-Assisted Bronchoscopy

  • REVIEW

Assessing and Managing Surgical Risk in Obstructive Sleep Apnea: A Narrative Review

  • REVIEW

Bronchiectasis: An Evidence-Based Approach to Diagnosis

  • REVIEW

Transbronchial Tumor Ablation

  • REVIEW

Primary Ciliary Dyskinesia: Integrating Genetics into Clinical Practice

  • Open Access
  • REVIEW

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Schützt das tägliche Glas Milch vor Darmkrebs?

Die Milch machts – sie bietet Frauen nach Daten einer großen Ernährungsanalyse den besten Darmkrebsschutz aller Lebensmittel, was am hohen Kalziumgehalt liegen dürfte. Am anderen Ende des Spektrums steht der Alkoholkonsum: Das Glas Wein am Abend ist eher ungünstig.

Vorsicht mit Glukokortikoiden bei Glomerulopathie

Auch niedrig dosierte Glukokortikoide zur Behandlung einer primären Glomerulopathie lassen offenbar die Infektionsgefahr steigen. In einer US-Studie hing das Risiko vor allem mit der kombinierten Anwendung von Immunsuppressiva zusammen.

KI-gestütztes Mammografiescreening überzeugt im Praxistest

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Jetzt 10 CME-Punkte sammeln

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise