Performance of a self-expanding silicone stent in palliation of benign airway conditions.

Abstract

INTRODUCTION:

The Polyflex stent (Boston Scientific; Boston, MA) is a self-expanding, thin-walled, silicone stent. Its use has been described in the management of patients with malignant airway obstruction, yet reports of its use for treatment of benign airway conditions are rare.

STUDY:

We report a retrospective review of our experience with the Polyflex stent in the management of benign airway conditions.

RESULTS:

A total of 16 stents were deployed in 12 patients. The indications for the stent placement included the following: anastomotic stenosis following lung transplantation (LTR) [four patients]; tracheal stenosis (three patients); tracheobronchomalacia (two patients); tracheobronchopathiaosteochondroplastica (one patient); relapsing polychondritis (one patient); and bronchopleural fistula (one patient). Even though immediate palliation was established in most cases (90%), the incidence of complications was 75%. Stent migration was the most common consequence, with time to the event ranging from < 24 h to 7 months. One stent was expectorated within < 24 h. One patient coughed up a portion of the inner lining of the stent 7 months after its placement. Emergent bronchoscopy was required in four patients for mucous impaction. The complication rate was 100% in patients with LTR-related anastomotic stenosis.

CONCLUSION:

The use of the Polyflex stent for the treatment of benign airway conditions is associated with a high complication rate. We have abandoned its use under such conditions in our practice.

• Authors: Thomas R Gildea, Sudish C Murthy, Debashish Sahoo, David P Mason, Atul C Mehta
• Journal: Chest (Chest) Vol. 130 Issue 5 Pg. 1419-23 (Nov 2006) ISSN: 0012-3692 [Print] United States
• PMID: 17099019 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Silicones

Topics

• Adult
• Aged
• Airway Obstruction (etiology, therapy)
• Anastomosis, Surgical
• Bronchial Fistula (complications)
• Female
• Humans
• Lung Transplantation (adverse effects)
• Male
• Middle Aged
• Palliative Care (methods)
• Polychondritis, Relapsing (complications)
• Retrospective Studies
• Silicones
• Stents (adverse effects)
• Tracheal Diseases (complications)
• Tracheal Stenosis (complications)