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Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?
Juan L Antón-Pacheco1, Carmen Luna1, Enrique García2
1Pediatric Airway Unit, Division of Pediatric Surgery, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
Insights
New biodegradable airway stents show promise for treating severe tracheobronchial obstruction in infants. These polydioxanone stents were safe and effective, leading to improved respiratory condition in all patients studied.
Area of Science:
- Pediatric Pulmonology
- Biomaterials in Medicine
- Respiratory Medicine
Background:
- Severe tracheobronchial obstruction in children presents significant management challenges.
- Traditional metallic or plastic stents carry risks of complications and may not be ideal for pediatric patients.
Objective:
To report our experience with a new type of biodegradable airway stent in the setting of severe tracheobronchial obstruction in children.
Design And Methodology:
We conducted a retrospective and prospective (since June 2014) study of pediatric patients with severe airway obstruction treated with biodegradable stents in our institution between 2012 and 2015. The following data were collected: demographics, indication for stenting, bronchoscopic findings, insertion technique complications, clinical outcome, stent related complications, re-stenting, and time of follow-up.
Results:
Thirteen custom-made polydioxanone stents were placed in four infants (mean age, 4 months) with severe tracheobronchial obstruction: tracheomalacia (two patients), bronchomalacia (1), and diffuse tracheal stenosis (1). All the stents were bronchoscopically inserted uneventfully. Immediate and maintained clinical improvement was observed in every case. No major stent related complications have occurred and only mild or moderate granulation tissue was observed during surveillance bronchoscopy. Two patients required repeated stenting as expected. All the patients are alive and in a good respiratory condition with a follow-up ranging from 5 to 40 months.
Conclusions:
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.
