P1.12-009 Experience with Fully Covered Metallic Stents in Patients with Malignant Airway Obstruction

Abstract

Airway stenting provides a solution to restore patency of the airways in patients with malignant conditions that are unsuitable for surgical procedures. Their use has been associated with significant improvement in symptoms and quality of life. There is little experience with recent commercially available fully covered metallic stents. All patients who underwent fully silicon covered nitinol mono-filament Aerstent® (Leufen, Bess, Germany) placement at the Hospital Universitari de Bellvitge from September 2013 and February 2017 were retrospectively reviewed for medical records, bronchoscopy and microbiological results, as well as stent related complications and patient survival. 66 stents were implanted in 54 patients during this 36 months period, with mean age of 59 years (43-81 years). The main indication of stent placement was lung cancer in 41 (76%) patients (22 squamous, 9 adenocarcinoma, 5 undetermined NSCLC, 4 small-cell lung cancer and 1 atypical carcinoid). Stents were deployed with rigid bronchoscopy under fluoroscopic control in main bronchus (n=42), trachea (n=7), and main carina (Y shape n=17). Photocoagulation with YAP laser and/or mechanical debulking was necessary in 44 (66.6%) procedures prior to stenting. Seven stents (10.6%) required repositioning after deployment using rigid grasping forceps. Major bleeding occurred in 12 procedures (18.1%) and was successfully managed with endoscopic methods. No immediate complications occurred after the procedures. In 52 cases (96.3%) immediate and significate clinical improvement in dyspnea was registered. Median survival after first stent deployment was 144 days (6-484). 7 patients died within 30 days after the procedure. 50 patients (92%) had stent related complications during follow up (Table 1). In our case series, Aerstent (Leufen, Bess) has provided immediate dyspnoea relief in 96.3% of patients, without significate complications during deployment or within the first 24 hours. Mucostasis is the most common complication (77%) and is detected during the first month (mean 28.2 days).