1. Long-term safety and tolerance of silicone and self-expandable airway stents: an experimental study
- Author
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Adriano Tocchi, Francesco Puma, Antonio Di Meo, Stefano Santoprete, Niccolò Daddi, Moira Urbani, Giuliano Daddi, Rodolfo Gialletti, and Raffaele Farabi
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Perforation (oil well) ,Silicones ,Constriction, Pathologic ,Prosthesis Design ,Prosthesis ,chemistry.chemical_compound ,Silicone ,Bronchoscopy ,medicine ,Animals ,cardiovascular diseases ,Bronchus ,Sheep ,business.industry ,Stent ,Bronchial Diseases ,equipment and supplies ,medicine.disease ,Squamous metaplasia ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,chemistry ,Stents ,Cardiology and Cardiovascular Medicine ,Complication ,Airway ,business - Abstract
Background . A variety of respiratory stents are currently available, but the ideal airway prosthesis seems far from being recognized. The objective of this study was to verify safety and long-term effect on the bronchial wall of three different types of airway stents. Methods . Twelve healthy adult sheep were divided in three groups, scheduled to receive: (1) bare self-expandable metallic stents (Gianturco); (2) silicone stents (Dumon); and (3) covered self-expandable synthetic stents (Polyflex). Insertions were performed through a rigid bronchoscope under general anesthesia. Chest roentgenogram was performed 1 and 6 months after surgery, and flexible bronchoscopy after 6 months. Twelve months postoperatively, the animals were killed and a postmortem examination was carried out. Results . All Polyflex stents migrated during the observation period; one late migration was observed in the Dumon group. Microscopic study showed: (1) Gianturco stents: full-thickness perforation of the bronchial wall covered by a thick layer of a chronic inflammatory infiltrate. Infection by Candida at the bottom of some ulcerations; (2) Dumon stents: mild bronchial inflammation (squamous metaplasia, submucosal inflammatory infiltrates; granuloma-like infiltrates). In case of displacement, no significant changes of the previously stented bronchus occurred; and (3) Polyflex stents: no changes of the previously stented bronchi. Conclusions . Gianturco stents proved unsafe in the long term, owing to the risk of severe airway wall damage. The Polyflex stent is well tolerated but presents a high migration rate. Silicone stents show several limitations but appear to be well tolerated by the host mucosa.
- Published
- 2000
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