Management of tracheobronchial obstruction in infants using metallic stents: long-term outcome

Leung, Louis M L; Chung, Patrick Ho Yu; Wong, Kenneth Kak Yuen; Tam, Paul Kwong Hang

doi:10.1007/s00383-015-3666-3

Cited by 19 publications

(14 citation statements)

References 33 publications

(52 reference statements)

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“…Severe complications such as: excessive granulation tissue formation, arteriobronchial fistulas, or airway perforation have been reported . Conversely, other authors communicate satisfactory long‐term outcomes in treating infants with airway metallic stents . Our own experience (seven patients with metallic stents in place for more than 5 years) demonstrates fewer complications than expected in the long‐term and a mild to moderate impact in the quality of life related to respiratory health (non published data).…”

Section: Discussionmentioning

confidence: 65%

“…Some authors state that the currently available stents for children can cause a high rate of severe complications that may supersede the airway compromise that necessitated their initial placement . Other reports show satisfactory outcomes with metallic and /or plastic stents . At the end, there seems to be a basic general agreement that stents may play a role in selected cases in which there are no surgical alternatives, or be a life‐saving procedure in extremely sick patients .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?

Antón‐Pacheco

Luna

García

et al. 2015

Pediatric Pulmonology

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Biodegradable airway stents seem to be safe, effective, and cause fewer complications than other types of stents. They can be an alternative to the classic metallic or plastic stents for severe tracheal stenosis or malacia in small children. More experience is needed in order to establish the definite clinical criteria for their use in pediatric patients. Pediatr Pulmonol. 2016;51:607-612. © 2015 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?

Antón‐Pacheco

Luna

García

et al. 2015

Pediatric Pulmonology

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show abstract

“…[161718] Although patients with malignancy usually have a low-performance status when stents are applied as palliative treatment, a long-term local therapy through airway stents for these patients is welcomed. [19] In some benign disease groups, such as serious tuberculosis, gas exposure, and inhalation burns, the multiplicity of involvement or the long length of stenosis segment increases the surgical challenge.…”

Section: Discussionmentioning

confidence: 99%

Paclitaxel Drug-eluting Tracheal Stent Could Reduce Granulation Tissue Formation in a Canine Model

Wang

Zhang

Wang

et al. 2016

Chinese Medical Journal

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Background:Currently available silicone and metallic stents for tracheal stenosis are associated with many problems. Granulation proliferation is one of the main complications. The present study aimed to evaluate the efficacy of paclitaxel drug-eluting tracheal stent in reducing granulation tissue formation in a canine model, as well as the pharmacokinetic features and safety profiles of the coated drug.Methods:Eight beagles were randomly divided into a control group (bare-metal stent group, n = 4) and an experimental group (paclitaxel-eluting stent group, n = 4). The observation period was 5 months. One beagle in both groups was sacrificed at the end of the 1st and 3rd months, respectively. The last two beagles in both groups were sacrificed at the end of 5th month. The proliferation of granulation tissue and changes in tracheal mucosa were compared between the two groups. Blood routine and liver and kidney function were monitored to evaluate the safety of the paclitaxel-eluting stent. The elution method and high-performance liquid chromatography were used to characterize the rate of in vivo release of paclitaxel from the stent.Results:Compared with the control group, the proliferation of granulation tissue in the experimental group was significantly reduced. The drug release of paclitaxel-eluting stent was the fastest in the 1st month after implantation (up to 70.9%). Then, the release slowed down gradually. By the 5th month, the release reached up to 98.5%. During the observation period, a high concentration of the drug in the trachea (in the stented and adjacent unstented areas) and lung tissue was not noted, and the blood test showed no side effect.Conclusions:The paclitaxel-eluting stent could safely reduce the granulation tissue formation after stent implantation in vivo, suggesting that the paclitaxel-eluting tracheal stent might be considered for potential use in humans in the future.

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“…Subsequently, a number of retrospective case series have been published. Two series with five patients each reported the long-term outcome of stents used in tracheal stenosis after endoscopic dilation, with good functional outcomes, but a high complication rate [103,134]. Another case series reported on rapamycin-eluting stents after balloon dilation of congenital tracheal stenosis in eight infants, but with only a short follow-up [135].…”

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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Management of tracheobronchial obstruction in infants using metallic stents: long-term outcome

Abstract: Endoscopic stenting with metallic stent has satisfactory long-term outcome in treating infants with tracheobronchial obstruction.

Cited by 19 publications

References 33 publications

Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?

Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?

Paclitaxel Drug-eluting Tracheal Stent Could Reduce Granulation Tissue Formation in a Canine Model

ERS statement: interventional bronchoscopy in children

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