Fully covered self-expandable metallic stents for malignant airway disorders

Abstract

Airway stenting is an established procedure for treating airway stenosis and fistulas. The AERO stent (Merit Medical Systems, South Jordan, UT, USA), a relatively new, fully covered, self-expandable metallic stent, was approved in Japan in 2014. This study evaluated the efficacy and safety of this stent for malignant airway disorders. Medical records of all patients at a single center, in whom the AERO stent was deployed between February 2015 and December 2017, were retrospectively reviewed. All procedures were performed using rigid and flexible bronchoscopes under general anesthesia. A total of 42 procedures were performed in 36 patients: 37 for treatment of airway stenosis and five for tracheoesophageal fistula. The AERO stents were successfully placed in 41 of 42 (98%) cases. The amount of oxygen could be reduced in 78% of patients who required oxygen therapy. Pulmonary function, including vital capacity, forced expiratory volume in 1 second, and peak expiratory flow, improved significantly after the procedures. Complications occurred in 14 (33%) cases; the most frequent complication was migration (6 cases). Fourteen stents were successfully removed without any complications. Placement of an AERO stent was effective and acceptably safe for treating malignant airway disorders. Because the AERO stent can be removed safely, it can be used for palliation or as a bridge to chemoradiotherapy.