Practice patterns for maintaining airway stents deployed for malignant central airway obstruction

Although significant experience exists in placing airway stents, and knowledge of stent-related complications is widespread, information is lacking regarding methods of surveillance and maintaining patency of these stents. The purpose of this investigation was to determine the actual practice patterns used by interventional pulmonologists for airway stent maintenance. We prospectively surveyed members of the American Association of Bronchology and Interventional Pulmonology or attendees at their annual meeting during Chest 2008. Sixty-two respondents returned the completed surveys and were included in the analysis. Practice settings included university (50%), single specialty (27%), community academic (11%), and multispecialty (11%) settings. Annual placement of stents was ≤10 (31%); 11 to 30 (45%); and >30 (24%). Considerable variability existed in both medications used for maintenance and surveillance schedules, and less than 50% protocolized postplacement management. Although stent placement is common among experienced interventional pulmonologists, half have no protocol for surveillance or maintenance. Similarly, there is no discernable consistency or standard practice pattern to monitor for or prevent stent failure. Further study is required to determine the best practices for postdeployment surveillance and maintenance of airway stents.