Coughing a fragment without stent failure: a rare presentation of airway stent damage

Sabia, Michelle; Alraiyes, Abdul Hamid; Dhillon, Samjot Singh; Harris, Kassem

doi:10.1111/crj.12558

Cited by 1 publication

(2 citation statements)

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“…Too much expansive radial force can cause tissue injury due to mucosal ischemia, while too little (or too much) can lead to stent migration (13). Metal fatigue and stent metal fragmentation are not uncommon phenomena (7,12). Stent deployment must be performed with care as the SEMS can follow the path of least resistance (non-stenotic airway segment) rather than staying engaged in the stenotic area (Figure 3).…”

Section: Current Airway Stenting Practice Patternsmentioning

confidence: 99%

“…Both can achieve airway patency and maintain ventilation of the lung parenchyma for a time. Without a precise fit into the area, complications can arise with either type of stent: plugging with or without concurrent infection (Figure 1), metal fatigue leading to fracture (Figure 2), migration (Figure 3), formation of granulation tissue (Figure 4), and mucosal incorporation with possible erosion and perforation (Figure 5) (7). Silicone stents and SEMS have individual advantages and disadvantages (Table 1).…”

Section: Current Airway Stenting Practice Patternsmentioning

confidence: 99%

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3D printing for airway disease

Alraiyes¹,

Avasarala²,

Machuzak³

et al. 2019

AME Med. J

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It has been 30 years since the first commercial three-dimensional (3D) printer was available on market. The technological advancement of 3D printing has far exceeded its implementation in medicine. The application of 3D printing technology has the potential of playing a major role within interventional pulmonology; specifically, in the management of complex airway disease. Tailoring management to the patient-specific anatomical malformation caused by benign or malignant disease is a major challenge faced by interventional pulmonologists. Such cases often require adjunctive therapeutic procedures with thermal therapies followed by dilation and airway stenting to maintain the patency of the airway. Airway-stent size matching is one key to reducing stent-related complications. A major barrier to matching is the expansion of the stent in two dimensions (fixed sizes in length and diameter) within the deformed airway. Additional challenges are created by the subjective oversizing of the stent to reduce the likelihood of migration. Improper sizing adversely affects the stability of the stent. The stent-airway mismatch can be complicated by airway erosion, perforation, or the formation of granulation tissue. Stents can migrate, fracture, obstruct, or become infected. The use of patient-specific 3D printed airway stents may be able to reduce the stent airway mismatch. These stents allow more precise stent-airway sizing and minimizes high-pressure points on distorted airway anatomy. In theory, this should reduce the incidence of the well-known complications of factory manufactured stents. In this article, the authors present the brief history of 3D printed stents, their consideration in select patients, processing steps for development, and future direction.

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Section: Current Airway Stenting Practice Patternsmentioning

confidence: 99%

Section: Current Airway Stenting Practice Patternsmentioning

confidence: 99%