Choosing the Right Stent for Each Type of Benign Tracheal Stenosis May Be Associated with Reduced Stent-Related...

In patients with benign tracheal stenosis (TS) deemed inoperable, silicone stents is an effective alternative. Although both straight and hourglass-shaped stents are available, little is known on the specific suitability of each stent. We aimed to evaluate the potential clinical benefit of choosing a specific stent for each case.

We compared clinical outcomes in patients undergoing stent placement, in two groups: group 1, when only straight silicone stents were available and group 2, when we could choose either straight or hourglass stent, depending on the anatomic characteristics of the stenosis. A scoring system based on clinical/functional/bronchoscopic characteristics was used to evaluate complications severity.

Between 2008 and 2023, 37 patients underwent tracheal stenting for PITS, comprising group 1 (n = 8) and group 2 (n = 29). No differences were observed between groups regarding stenosis type, location, length, or baseline dyspnoea. Group 2 demonstrated a significantly lower stent/patient ratio (1.24 vs. 1.87, p = 0.001) and higher rates of clinical success (29 vs. 6 cases, p = 0.014). The Complication Severity Index (CSI) was significantly lower in group 2 (0.8 vs. 1.3, p = 0.016). Patients bearing straight stents in group 2, had a lower stent/patient ratio compared with group 1 (1.50 vs. 1.87, p = 0.044) and improved outcomes (10 vs. 6 cases, p = 0.043), with a lower CSI (0.85 vs. 1.3, p = 0.025). In group 2, hourglass stents had a lower stent/patient ratio than straight stents (1.14 vs. 1.50, p = 0.038).

Choosing the fittest stent for each type of TS generates fewer complications and increased efficacy. Our results indicate that hourglass stents may comply better to annular TS.