AIRWAY STENTS FOR EXCESSIVE DYNAMIC AIRWAY COLLAPSE: A RANDOMIZED CONTROLLED TRIAL

Abstract

SESSION TITLE: Cardiothoracic Surgery SESSION TYPE: Original Investigations PRESENTED ON: 10/09/2018 10:45 AM - 11:45 AM PURPOSE: Excessive dynamic airway collapse (EDAC) is an underdiagnosed disease that causes increased dyspnea, recurrent bronchopulmonary infections and intractable cough leading to impaired quality of life. Patients with severe symptomatic EDAC often undergo a stent trial to assess whether such symptoms improve and thus are candidates for more definitive surgical airway stabilization. The objective of this study is to evaluate the efficacy of short term use of airway stents along with medical management as compared to medical management alone in patients with severe EDAC. METHODS: Interim analysis of a randomized control trial of patients with severe symptomatic EDAC who underwent a stent trial with medical management (group 1) as compared to medical management alone (group 2). Baseline measurements were compared to those obtained after 7-14 days. Measurements included: Modified Medical Research Council (mMRC), Cough Quality of Life Questionnaire (CQLQ), spirometry testing and 6-Minute Walk Test (6MWT). Stent- and procedure-related complications were reported. RESULTS: A total of 9 patients are included so far: 5 were randomized to group 1 (2 had Y-silicone stent placement and 3 had uncovered self-expanding metallic stent) and 4 to group 2 (table 1). Presenting symptoms in group 1 as compared to group 2 were: dyspnea (80% vs. 100%), intractable cough (80% vs.75%), inability to clear secretion (60% vs. 50%) and recurrent infections (60% vs. 25%). Dyspnea, cough, and secretion clearance in group 1 as compared to group 2 improved in: (75% vs. 25%), (60% vs 0%) and (33.3 vs 50%) respectively. Overall; there was no clinically important improvement in mMRC and CQLQ in group 1 versus group 2. However, there was a clinically significant improvement in 6 MWT and FEV1 in group 1 as compared to group 2. All stents were removed without any complications and there were no procedural related events. CONCLUSIONS: This interim analysis showed that short-term stent trial appears to improve respiratory symptoms, lung function test and exercise capacity in patients with severe symptomatic EDAC when performed by a multidisciplinary airway team in highly specialized centers with experience in the evaluation and treatment of such a population. CLINICAL IMPLICATIONS: Patients with severe and symptomatic EDAC might benefit from a short-term stent trial to assess whether definitive surgical airway stabilization is warranted or not. DISCLOSURES: No relevant relationships by Daniel Alape-Moya, source=Web Response Consultant relationship with Boston Scientific Please note: $1-$1000 Added 03/02/2018 by Alex Chee, source=Web Response, value=Consulting fee No relevant relationships by Sidhu Gangadharan, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $5001 - $20000 Added 03/04/2018 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with Olympus Please note: $5001 - $20000 Added 03/04/2018 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response no disclosure on file for Jennifer Wilson