Decreased granulomatous reaction by polyurethane‐coated stent in the trachea

Matsui, Hikoro; Hiroma, Takehiko; Hasegawa, Hisaya; Ogiso, Yoshifumi

doi:10.1111/ped.12360

Cited by 12 publications

(8 citation statements)

References 16 publications

(28 reference statements)

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“…We believe that the granulation tissue hyperplasia on the upper edge of the stent may be related to the friction occurring between the stent and the airway wall during respiration and coughing, while that occurring in the middle of the stent may be related to the excessive pressure at the narrowest part. Similar findings were reported by Matsui H et al, who showed that direct contact between the stent wire and the airway wall resulted in inflammatory changes and destruction of the epithelial structure of the airway, resulting in hyperplasia of the scar tissue; they observed that the polyurethane-coated metal stent has low biological activity against the airway epithelial cells and can therefore alleviate foreign body reactions [16]. In another retrospective study, Chung FT et al reported that patients who underwent stent implantation less than 3 months after lung transplantation were prone to restenosis; they may also have associated local tissue inflammation, which further promotes granulation hyperplasia in the stent [17].…”

Section: Discussionsupporting

confidence: 87%

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Qiu

Liu

Zhang

et al. 2022

JCM

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Background: Airway stent implantation used in the treatment of benign cicatricial airway stenosis (BCAS) can lead to local granulation and scar formation, resulting in restenosis and treatment failure. Methods: We systematically investigated a paclitaxel-loaded PLGA-coating stent (PLPCS) and analyzed the safety and efficacy of the PLPCS in patients with BCAS. Patients were enrolled from four hospitals in China and observed for six months after implantation, by bronchoscopy performed weekly in the first month and monthly thereafter. The stent was removed immediately upon detection of granulation tissue proliferation, leading to immobility of the stent. Results: Granulation tissue was formed one week after stent implantation, most of which was located at the upper edge of the stent and the narrowest airway in the stent. All stents were removed in three months (mean: 6.51 + 4.67 weeks), with a curative outcome in one case and ineffective results in two. The remaining seven patients developed complications within three months, necessitating early stent removal. The main complication was granulation formation, resulting in difficulty in stent removal. Conclusion: Although PLPCS showed beneficial effects in basic and animal experiments, it cannot prevent airway restenosis in actual practice, mainly due to granulation formation.

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Section: Discussionsupporting

confidence: 87%

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Qiu

Liu

Zhang

et al. 2022

JCM

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“…Cuffs coated with MPC showed less epithelial abrasion and reduced proliferation of goblet cells. Matsui et al () used polyurethane to prevent granulation from the tracheal stent and demonstrated that the polyurethane‐coated metallic stent led to decreased injury and biohistological reaction to the tracheal epithelium. However, the outcomes of these studies were based only on endoscopic or histologic findings such as grade of tracheal stenosis, number of inflammatory cells, and area of fibrosis, therefore analysis of the mechanism of the preventive effect against fibrosis or granulation could not be included.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have aimed to decrease mucosal damage, and thereby prevent tracheal stenosis, by coating the endotracheal tube or trachea stent with materials such as polyurethane (Matsui, Hiroma, Hasegawa, & Ogiso, ), hyaluronic acid (HA)/polyethylene glycol (PEG; Choi et al, ), and 2‐methacryloyloxyethyl phosphorylcholine polymer (PMB; Ito et al, ). In animal model, the tissue granulation was reported to be suppressed by polyurethane‐stent (75.00%), HA‐tube (51.85%), and PEG‐tube (34.03%) compared to noncoated tube.…”

Section: Introductionmentioning

confidence: 99%

Fabrication and biological activity of polycaprolactone/phlorotannin endotracheal tube to prevent tracheal stenosis: An in vitro and in vivo study

Lee

Jeong

et al. 2019

J Biomed Mater Res

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Prolonged endotracheal intubation is the most common cause of tracheal stenosis, which may lead to serious airway obstruction. Development of an endotracheal tube coated with biomaterials that exhibit anti‐inflammatory or anti‐fibrogenic effects may prevent tracheal stenosis. This study demonstrates that an endotracheal tube coated with phlorotannin, which is present in extracts of the brown alga Ecklonia cava, can prevent tracheal stenosis in a rabbit model. An in vitro study shows that phlorotannin inhibits proliferation of human tracheal fibroblasts treated with transforming growth factor β1. Phlorotannin‐coated endotracheal tubes show steady release of phlorotannin for up to 7 days, and removal of the tube 1 week after insertion reveals a reduction in both fibrogenesis and thickening of tracheal submucosa. Western blot analysis of tracheal tissues after removal of the phlorotannin‐coated tube shows decreased protein expression levels of phenotypic markers of fibrosis such as collagen type I and α‐smooth muscle actin. The ability of phlorotannin‐coated endotracheal tube to prevent tracheal stenosis caused by endotracheal intubation indicates that phlorotannin may be considered as a candidate biomaterial for coating the cuff of endotracheal tubes to prevent tracheal stenosis.

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“…The woven technology can be combined with growth factors and drugs to achieve further optimization of the stent. Drug-eluting [ 75 ], surface modification [ 76 , 77 ], coating treatment [ 78 , 79 ], and tissue engineering in vitro culture [ 80 , 81 ] are all conducive to the vascularization and improvement of antibacterial performance of stents.…”

Section: Challenges and Future Prospectsmentioning

confidence: 99%

A Review of Woven Tracheal Stents: Materials, Structures, and Application

Chen

Huang

et al. 2022

JFB

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The repair and reconstruction of tracheal defects is a challenging clinical problem. Due to the wide choice of materials and structures, weaving technology has shown unique advantages in simulating the multilayer structure of the trachea and providing reliable performance. Currently, most woven stent-based stents focus only on the effect of materials on stent performance while ignoring the direct effect of woven process parameters on stent performance, and the advantages of weaving technology in tissue regeneration have not been fully exploited. Therefore, this review will introduce the effects of stent materials and fabric construction on the performance of tracheal stents, focusing on the effects of weaving process parameters on stent performance. We will summarize the problems faced by woven stents and possible directions of development in the hope of broadening the technical field of artificial trachea preparation.

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Decreased granulomatous reaction by polyurethane‐coated stent in the trachea

Abstract: The new polyurethane-coated metallic stent maintains enough holding force, and reduces histobiological reaction to foreign bodies in this experiment.

Cited by 12 publications

References 16 publications

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Fabrication and biological activity of polycaprolactone/phlorotannin endotracheal tube to prevent tracheal stenosis: An in vitro and in vivo study

A Review of Woven Tracheal Stents: Materials, Structures, and Application

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