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Progressive experience in tracheal stenting with self-expandable stents
Marc Remacle1, Georges Lawson, Jacques Jamart
1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne, Avenue Therasse 1, 5530 Yvoir, Belgium. remacle@orlo.ucl.ac.be
Summary
Stainless steel stents showed high complication rates. Nitinol mesh stents and silicone-covered prostheses offer improved palliative treatment options for tracheal stenosis and tumors, with better patient outcomes and fewer complications.
Area of Science:
- Interventional Pulmonology
- Biomaterials Engineering
Background:
- Stainless steel Gianturco stents had a high complication rate (21%), including fractures and migrations.
- Previous treatments for tracheal stenosis and tumors presented significant challenges.
Purpose of the Study:
- To evaluate the efficacy and safety of nitinol mesh stents and silicone-covered prostheses for palliative treatment of tracheal conditions.
- To compare outcomes with previous stainless steel stent use.
Main Methods:
- Nitinol mesh stents (Ultraflex) used for 15 patients with fibrous tracheal stenosis.
- Silicone-covered prostheses (Rush) used for 2 patients with inoperable tracheal tumors.
- Procedures performed under endoscopic guidance; patient outcomes assessed via spirometry and complication monitoring.
Main Results:
- Median forced inspiratory volume in 1 s (FIV1) improved significantly (P=0.018).
- Improved peak inspiratory flow to peak expiratory flow ratio (PIF 50%/PEF 50%).
- Low complication rates observed with new devices; granulomas were manageable, and no stent fractures occurred.
Conclusions:
- Nitinol mesh stents are effective for palliative management of fibrous tracheal stenosis.
- Silicone-covered prostheses are suitable for inoperable tracheal tumors.
- These alternative prostheses offer a safer and more effective palliative treatment strategy.