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Pulmonary Procedures |

Silicone Stent Customization for Complex Airway Disorders - A Single Center Experience FREE TO VIEW

Anupam Kumar, MD; Hanine Inaty, MD; Satish Kalanjeri, MD; Thomas Gildea, MD
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Cleveland Clinic, University Heights, OH


Chest. 2015;148(4_MeetingAbstracts):847A. doi:10.1378/chest.2275300
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Abstract

SESSION TITLE: Rigid Bronchoscopy

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Airway stents are being increasingly used for various airway disorders. Despite a wide array of stents available in the market today, stent customization is often needed to obtain a satisfactory fit, or to prevent migration. We report preliminary data on single center 1 year experience with stent customization.

METHODS: A retrospective analysis of our database of silicone stent implantation for the last year was performed. The study reviewed the indications and location of stent insertion, type of customization and final measurement of the stent. Types of customization were categorized as notching, shortening, occlusion, hole creation, extension, angulation and others.

RESULTS: 63 silicone stents were inserted in 33 patients in the 1 year period. 54/63 (85%) of the stent insertion were performed for benign disorders while rest were malignant. 52%(33/63) of the stent implantation was performed for bronchial stenosis of varying etiology.Stent customization had to be done for 43 of the stents implanted. A total of 71 customizations were done in the 43 stents with a mean of 1.65 customizations per stent. Stent shortening (n =25, 35%) was the most common type of modification, followed by length extension (n=20, 28%). Other modifications included (n=17, 24%), angulation (n=6, 8.5%), occlusion (n=2, 3%) and creating a hole (n=1, 1.5%). There were no complications as a direct consequence of stent customization.

CONCLUSIONS: Silicone stents are available in different sizes. In our single center experience, customization of the stent is often the rule than an exception to enable satisfactory fit in often distorted airways. Stent shortening was the most common customization performed.

CLINICAL IMPLICATIONS: ​A wide range of stents in different standard sizes are available in the market today. However, airway shape, luminal size, pattern of stricture and anatomy vary among patients. Standard size stents often do not always offer satisfactory fit, and are prone to complications such as migration, mucosal irritation and granulation tissue formation. Stent customization is therefore often necessary in minimizing these issues. Our experience with a large number of stents insertions in complex cases proves feasibility and success in stent modifications and customizations. Until more accurate customization techniques such as 3D printing are readily available, experienced interventional pulmonologists will continue to rely on innovative techniques as described above to maximize benefit and reduce complications from stent insertion.

DISCLOSURE: The following authors have nothing to disclose: Anupam Kumar, Hanine Inaty, Satish Kalanjeri, Thomas Gildea

No Product/Research Disclosure Information


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