An Airway Wallstent for the treatment of tracheobronchial malignancies

The palliative effect of a new Airway Wallstent with a polyurethane covering was tested in patients with inoperable malignant lesions of the central airways.

Thirty six stents were inserted in 27 patients with obstruction (n = 24) or fistulae (n = 3), 15 of whom later received radiotherapy. The degree of symptom relief was assessed 1, 30, and 90 days after stent insertion.

Stent deployment was successful in all patients. Significant improvements were observed one day after placement compared with before placement, with no change at 30 and 90 days, in dyspnoea index (mean (SD) 3.2 (0.7) before stent insertion compared with 1.8 (0.7) one day after insertion); Karnofsky index (32 (18) before insertion compared with 55 (15) one day after insertion); and obstruction of airway diameter (85 (11)% before insertion compared with 10 (12)% on day 1 after stent insertion). Stent-related complications needing later interventions included retained secretions (five patients), granuloma formation at ends of the stent (four patients), and stent migration (four patients). Over a median observation period of two months (range two days to 8.5 months) all stent coverings remained intact without delamination or tumour ingrowth.

The Airway Wallstent provided excellent palliation for malignant obstructions and fistulae of the central airways. Retention of secretions and granuloma formation at the ends of the stent warrant minor technical improvements.