Biodegradable airway stents in infants – Potential life-threatening pitfalls

Sztanó, Balázs; Kiss, G.; Márai, K.; Rácz, Gábor; Szegesdi, Ilona; Rácz, Katalin; Katona, Gábor; Rovó, László

doi:10.1016/j.ijporl.2016.10.013

Cited by 45 publications

(48 citation statements)

References 19 publications

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“…• Biodegradable stents have theoretical advantages in some circumstances, but they have a tendency to dissolve too early and severe complications (death due to stent fragmentation and aspiration) have been reported [132,133]. Clearly, biodegradable material would be preferable, as it could avoid the long-term consequences of ingrown metal mesh stents as well as the secretion retention, granulation and displacement issues of removable covered or silicone stents.…”

Section: Airway Stentsmentioning

confidence: 99%

ERS statement: interventional bronchoscopy in children

et al. 2017

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Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives. There is a scarcity of published evidence in this field, and in many cases the task force had to resort to the collective clinical experience of the committee to develop this statement. The highlighted gaps in knowledge underline the need for further research and serve as a call to paediatric bronchoscopists to work together in multicentre collaborations, for the benefit of children with airway disorders.

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Section: Airway Stentsmentioning

confidence: 99%

ERS statement: interventional bronchoscopy in children

et al. 2017

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“…2,[9][10][11]16 So far, PDS stents have been used mostly in the treatment of tracheal and bronchial compression after cardiovascular procedures, 9 after a failed aortopexy, 10 after tracheoplasty due to congenital stenosis 11 or in the cases of severe tracheo-and bronchomalacia. 12,17,18 We found the offered polydioxanon self-expanding stents CS-ELLA very suitable for the use in pediatric patients. The mechanism of self-expansion and thus selffixing is one of the greatest advantages of PDS stents.…”

Section: Discussionmentioning

confidence: 92%

Biodegradable airway stents: Novel treatment of airway obstruction in children

Zając¹,

Krysta²,

Kiszka³

et al. 2019

Adv Clin Exp Med

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Background. Tracheobronchomalacia is the most common cause of congenital airway obstruction in infants. An alternative for surgical approach (aortopexy) can be metallic airway stents. Usually, they are not considered as a first choice because of the relatively high risk of complications. Recent years have brought encouraging reports of biodegradable stents applied in children. Objectives. The aim of this study was to report our experience in the treatment of airway malacia using biodegradable stents. Material and methods. Six polydioxanone (PDS), self-expanding custom-made stents (ELLA-CS) were implanted in 2 children: 3 in the patient with left main bronchus occlusion due to postpnemonectomy syndrome and 3 stents in the baby with tracheomalacia. Results. Airway collapse was always relieved after stent expansion. Both patients needed repeated stenting because of limited stent lifespan. All the stents were implanted without complications through a rigid bronchoscope. The baby with stented main bronchus died because of irreversible lung lesion. Conclusions. This small study shows that biodegradable airway stents seem to be an attractive option in the treatment of tracheobronchomalacia in children. We consider this method to be safe, effective, repeatable, and reversible in small children with growing airways. As a time-buying procedure they can be especially useful in the treatment of tracheobronchomalacia.

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“…Se disuelve por completo hacia la semana 15, por lo que no es necesaria su remoción y permite el crecimiento subsiguiente de la vía aérea. 1,2,4,5,11 Después de la semana 15, no hay residuos de fibra en el epitelio ni en la lámina propia. La cantidad de granulación disminuye y solo se evidencia tejido cicatricial mínimo e infiltración linfoplasmocitaria residual.…”

Section: Figura 3 a Tomografía Computada Mediciones Del Bronquio Funclassified

“…4,5 Sin embargo, se describieron casos en los que los fragmentos en descomposición ocasionaron obstrucción respiratoria. 2 Además, la degradación del estent en un período relativamente corto puede requerir su recolocación y limitar su uso en enfermedad crónica o cuando se requiere la prótesis por un tiempo prolongado. 1,6 Su costo es elevado.…”

Section: Figura 3 a Tomografía Computada Mediciones Del Bronquio Funclassified

“…Generalmente, es causada por lesiones no malignas, como la malacia y la estenosis congénita o adquirida secundaria al trauma de la intubación endotraqueal o a la traqueotomía. [1][2][3] Las prótesis o estents de la vía aérea son dispositivos cilíndricos huecos que se colocan en la tráquea o el bronquio a fin de mantener la permeabilidad luminal y las dimensiones de una estructura tubular mediante la oposición a fuerzas compresivas extrínsecas, lo que provee un soporte interno. 3,4 Son empleadas para el tratamiento de la enfermedad obstructiva, estenótica o fistulosa de la vía aérea, ya sea de etiología benigna o maligna, cuando otros procedimientos quirúrgicos y/o endoscópicos han fracasado o no están indicados.…”

Section: Introductionunclassified

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Stent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

Cuestas

Rodríguez

Doormann

et al. 2018

Arch Argent Pediatr

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Presentación de casos clínicos RESUMENLa obstrucción bronquial es infrecuente en el niño. La causa principal es la malacia o la estenosis de naturaleza benigna. Las alternativas de manejo varían desde el tratamiento conservador hasta complejas técnicas quirúrgicas y/o endoscópicas. La colocación de una endoprótesis (estent) puede desempeñar un papel fundamental en situaciones particulares en las que no hay otra opción terapéutica. Sin embargo, el estent ideal aún no está disponible. En los últimos años, se han comenzado a investigar las propiedades de diversos materiales biodegradables a fin de superar los inconvenientes de los estents tradicionales confeccionados de silicona o metal. Se presenta nuestra experiencia con un nuevo tipo de estent de vía aérea biodegradable en el tratamiento de la broncomalacia grave en un niño de 2 años; se evalúa su seguridad y eficacia clínica. Se describen las indicaciones y las potenciales complicaciones del uso de endoprótesis en la vía aérea en pediatría. Palabras clave: estents, vía aérea, implantes biodegradables, constricción bronquial, niño. ABSTRACTBronchial obstruction is infrequent in the child. The main cause is malacia or benign stenosis. Management alternatives range from conservative treatment to complex surgical and/ or endoscopic techniques. Placement of a stent can play a key role in situations where there is no other therapeutic option. However, the ideal stent is not yet available. In the last few years, progress has been made in the development and characterization of novel biodegradable materials in order to overcome the drawbacks of traditional stents made of silicone or metal. Estent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

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Biodegradable airway stents in infants – Potential life-threatening pitfalls

Cited by 45 publications

References 19 publications

ERS statement: interventional bronchoscopy in children

ERS statement: interventional bronchoscopy in children

Biodegradable airway stents: Novel treatment of airway obstruction in children

Stent de vía aérea biodegradable para el tratamiento de la obstrucción bronquial en el niño. Caso clínico

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