Novel Silicone Stent to Treat Tracheobronchial Lesions: Results of 35 Patients

• Published in: Asian cardiovascular & thoracic annals Vol. 18; no. 6; pp. 521 - 528
• Main Authors: Saueressig, Maurício G, Sanches, Paulo RS, Neto, Amarilio V Macedo, Moreschi, Alexandre H, Oliveira, Hugo G, Xavier, Rogerio G
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-12-2010
• Subjects: Adult; Aged; Airway Obstruction - diagnostic imaging; Airway Obstruction - etiology; Airway Obstruction - mortality; Airway Obstruction - therapy; Brazil; Bronchial Diseases - diagnostic imaging; Bronchial Diseases - mortality; Bronchial Diseases - therapy; Bronchoscopy - adverse effects; Bronchoscopy - instrumentation; Catheterization; Chi-Square Distribution; Device Removal; Dyspnea - etiology; Dyspnea - therapy; Female; Humans; Intubation, Intratracheal - adverse effects; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasms - complications; Palliative Care; Proportional Hazards Models; Prosthesis Design; Radiography; Silicones; Stents; Time Factors; Tracheal Stenosis - diagnostic imaging; Tracheal Stenosis - etiology; Tracheal Stenosis - mortality; Tracheal Stenosis - therapy; Tracheomalacia - complications; Tracheostomy - adverse effects; Treatment Outcome; Tracheomalacia; Tracheal Stenosis; Stents; Airway Obstruction
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/0218492310388428

We describe a case series of 35 patients with either benign (14) or malignant (21) tracheal stenosis who were treated using a novel silicone stent, the HCPA-1, designed to prevent migration. Between March 2001 and September 2008, 13 women and 22 men received 41 HCPA-1 stents. The median duration of stenting in benign cases was 457 days (range, 4–2, 961 days). Successful stent removal with curative results was accomplished in 2 patients with tracheomalacia and 1 with post-intubation stenosis. In malignant cases, the median duration of stenting was 162 days (range, 1–1, 279 days). Five patients had tumor progression with obstruction requiring repeated laser resection, dilatation, or additional stents. Two patients died due to airway obstruction despite bronchoscopic intervention. Twelve patients with malignant lesions died with the stent in place. At the end of the study, 3 patients with malignant disease remained alive; 2 were lost to follow-up. The HCPA-1 stent proved to be safe, with no severe complications during the study period, and effective in improving quality of life with relief of dyspnea.