The (Hour)glass Half-Full: Modified Silicone Hourglass Stents for the Treatment of Central Airway Obstruction

Sabath, Bruce F.; Casal, Roberto F.

doi:10.7759/cureus.15501

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Tracheobronchial silicone stents were first described by Dumon in 1990 [43]. Unlike metallic stents, silicone stents must be deployed using a rigid bronchoscope, but can be customized at the time of procedure [44,45]. For instance, the stent can be cut to a certain length and side holes can be cut out to allow for ventilation of the bypassed normal airway branches.…”

Section: Silicone Stentsmentioning

confidence: 99%

Airway Stents in Interventional Pulmonology

Bashour,

Lazarus

2024

JoR

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Airway stents, first developed in the 1980s, have become fundamental in managing a multitude of airway pathologies and complications within the field of interventional pulmonology. The primary function of an airway stent is to re-establish airway patency and integrity when obstruction, stenosis, anastomotic dehiscence, or fistulae develop as a result of various malignant or benign conditions. Nevertheless, airway stents are foreign bodies that can result in complications. In this review article, we will discuss airway stents and their ongoing role in the management of several malignant and benign diseases. We will describe indications for airway stenting and review the elements that must be taken into consideration for optimal patient and stent selection. Given the prevalence of data regarding therapeutic bronchoscopy and airway stenting in malignant airway obstruction, much of the discussion in this review will focus on stent placement for that indication. We will also review the data as it pertains to safety, efficacy, and complications after stent placement, and conclude with a discussion of the future applications and research avenues related to airway stents.

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Section: Silicone Stentsmentioning

confidence: 99%

Airway Stents in Interventional Pulmonology

Bashour,

Lazarus

2024

JoR

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“…They are typically lined with studs that help anchor the stents to the airways but also allow a small space between the airway and the stent, allowing for the continued benefit of mucociliary function. Given their intrinsically-variable shape, the Y and hourglass stents, in particular, can be creatively modified to tailor to the needs of a given obstructed airway ( 19 , 20 ).…”

Section: Stent Selectionmentioning

confidence: 99%

Airway stenting for central airway obstruction: a review

Sabath¹,

Casal²

2023

Mediastinum

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Central airway obstruction is a serious complication of various diseases, most often malignancy. Malignant etiologies include primary lung cancer as most common though metastases from various other cancers can obstruct the airways as well. Benign etiologies include inflammatory or fibrotic changes due to prior airway interventions (e.g., endotracheal intubation or tracheostomy) or specific autoimmune conditions. Different interventional modalities exist including various electrosurgical or mechanical debulking tools, though these are sometimes insufficient or contraindicated for the purpose of restoration of airway patency. The placement of stents is thus needed in certain particularly complex or refractory cases. Airway stenting requires careful patient selection and stent selection along with a thorough knowledge of relevant anatomy and procedural technique. Indeed, certain clinical presentations are better suited for stent placement and more likely to achieve a symptomatic benefit. Moreover, a variety of stents exist with each having different attributes that may better fit specific conditions. Complications must be managed properly as well. These include stent migration, granulation tissue formation, and stent-related infection which can have clinically significant consequences. In this review, we will discuss airway stenting for central airway obstruction with regard to these various subject areas as well as conclude with discussion of future research directions.

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“…The Dumon ‘hourglass’ model (BostonMedical Products, Westborough, MA) was designed for cases with intrinsic or extrinsic luminal compression that abruptly change diameter, such as in subglottic stenosis, consequently preventing single‐diameter stents from fitting properly 16 . Silicone Y stents have been used for many decades.…”

Section: Types Of Airway Stentsmentioning

confidence: 99%

Tracheobronchial stents: an expanding prospect

Lilburn,

Williamson,

Phillips

et al. 2023

Internal Medicine Journal

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The first dedicated tracheobronchial silicone stent was designed by the French pulmonologist Jean‐Paul Dumon. The most common indications for stenting are to minimise extrinsic airway compression from mass effect, maintain airway patency due to intrinsic obstruction or treat significant nonmalignant airway narrowing or fistulae. Silicone stents require rigid bronchoscopy for insertion; however, they are more readily repositioned and removed compared with metallic stents. Metallic stents demonstrate luminal narrowing when loads are applied to their ends, therefore stents should either be reinforced at the ends or exceed the area of stenosis by a minimum of 5 mm. Nitinol, a nickel‐titanium metal alloy, is currently the preferred material used for airway stents. Airway stenting provides effective palliation for patients with severe symptomatic obstruction. Drug‐eluting and three‐dimensional printing of airway stents present promising solutions to the challenges of the physical and anatomical constraints of the tracheobronchial tree. Biodegradable stents could also be a solution for the treatment of nonmalignant airway obstruction.

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The (Hour)glass Half-Full: Modified Silicone Hourglass Stents for the Treatment of Central Airway Obstruction

Cited by 3 publications

References 10 publications

Airway Stents in Interventional Pulmonology

Airway Stents in Interventional Pulmonology

Airway stenting for central airway obstruction: a review

Tracheobronchial stents: an expanding prospect

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