Application of 3D Printing for Patient-Specific Silicone Stents: 1-Year Follow-Up on 2 Patients

Abstract

Managing complex benign airway disease is a major challenge in interventional pulmonology. Airway stent placement can result in complications due to a variety of factors, including poor fit of the stent in the airway. We report the 1-year outcome of 2 patients with airway disease caused by granulomatosis with polyangiitis (Wegener’s) affecting the left main bronchus and secondary carina. These patients had not responded to systemic therapy or standard bronchoscopic techniques and had complications with commercially available airway stents. We describe a first-in-human, clinical experience to address these issues. Using computed tomography (CT) imaging and 3D printing technology, we generated and implanted patient-specific silicone airway stents to address airway disease. 3D patient-specific stent prescription was created using a CT scan of the patient’s chest and a proprietary software package originally developed for orthopedic surgical planning. Silicone stents were manufactured and implanted. Observation for > 1 year after implantation compared to the 6 months prior to patient-specific stent implant were compared for the number, clinically required stent changes, procedure time, and general clinical improvement per usual standard of care after airway stenting. Patients showed improved durability, a shorter procedure time, and improvement of patient-reported symptoms leading to a reduced need for stent changes and modifications. The use of 3D printing technology to make patient-specific silicone stents is feasible with early clinical proof of concept noting a durable improvement over 1 year of follow-up.

Bronchoscopic treatment of inoperable nonsmall cell lung cancer

“…Personalised airway stents are another area of significant interest. Though not studied extensively in patients with NSCLC, three-dimensional printing to create individualised stents has been used in selected patients with some success [97,98]. Likewise, biodegradable stents have been used in limited patients with benign disease states to prevent complications of stenting in patients who require longer term airway support [99,100].…”

Therapeutic bronchoscopy for central airway diseases

“…The first published use of an airway customised three-dimensional (3D)-printed silicone stent took place in France in 2017. This stent was used successfully on a patient with stenosis and partial dehiscence of the bronchial anastomosis in his lung allograft [35]. More recently, US FDA clearance to implant a 3D-silicon stent that had been customised for compassionate use was obtained for the first time in the USA.…”

3d Printed Laryngoscope for Endotracheal Intubation

“…AM is especially beneficial in the medical field, allowing for patientspecific devices and implants with complex structures to be fabricated relatively more cost-effectively than with other methods [1]. Because of this, 3D printers have been used to produce implants, stents, scaffolds, and other customised devices with individual anatomic features tailored to the patient for successful and safe application [2][3][4][5]. When fabricating medical devices and implants, it is of the utmost importance that the material used does not harm or contaminate the patient.…”