Airway Stents: Changing paradigms in the management of airway stenosis

Abstract

Introduction: Central Airway Obstruction (CAO) is life threatening condition and caused by various benign and malignant conditions. Airway Stents (AS) are used to alleviate symptoms by providing patency to airway lumen. AS have gone timely modifications over the years and the reasons for their use have varied. We present a retrospective analysis of 40 patients, who underwent AS placement at our center Methods: 40 patients, who underwent stent placement for CAO were included in this retrospective analysis. The stenotic segment was identified, and AS were introduced using rigid bronchoscopy under general anesthesia. Self-expanding Metal-Stents (SEMS) used were Ultraflex (7), Leufen Aerstent (8), Hanaro (4) Nitinol (2), others (2), polymer-stents used were Dumon (12), Vergnon (2) Polyflex (1) and Biodegradable Stents (4). Results: 26 M and 14 F with mean age of 65±13 yrs were included in this study. The underlying pathology was benign in 16 and malignant in 24 patients. Length of CAO was ≤ 4 cm in 29 and >4 cm in 6 patients. 5 cases presented with a fistula. Complications included granulation tissue formation (3), migration (8) and mucostasis (1). The location, type and complications of AS are summarized in Table 1. Discussion: Our analysis gives an overview about the choice and possible complications of AS. Migration occurred mostly in polymer AS (5/8) and those introduced in intermediate Bronchus (3/6). Though the AS are relatively safe, but complications such as migration need to be timely anticipated and sent securing procedure may be considered in such situations.