Biodegradable airway stents: Novel treatment of airway obstruction in children.


Journal

Advances in clinical and experimental medicine : official organ Wroclaw Medical University
ISSN: 1899-5276
Titre abrégé: Adv Clin Exp Med
Pays: Poland
ID NLM: 101138582

Informations de publication

Date de publication:
07 2019
Historique:
pubmed: 15 6 2019
medline: 31 8 2019
entrez: 15 6 2019
Statut: ppublish

Résumé

Tracheobronchomalacia is the most common cause of congenital airway obstruction in infants. An alternative for surgical approach (aortopexy) can be metallic airway stents. Usually, they are not considered as a first choice because of the relatively high risk of complications. Recent years have brought encouraging reports of biodegradable stents applied in children. The aim of this study was to report our experience in the treatment of airway malacia using biodegradable stents. Six polydioxanone (PDS), self-expanding custom-made stents (ELLA-CS) were implanted in 2 children: 3 in the patient with left main bronchus occlusion due to postpnemonectomy syndrome and 3 stents in the baby with tracheomalacia. Airway collapse was always relieved after stent expansion. Both patients needed repeated stenting because of limited stent lifespan. All the stents were implanted without complications through a rigid bronchoscope. The baby with stented main bronchus died because of irreversible lung lesion. This small study shows that biodegradable airway stents seem to be an attractive option in the treatment of tracheobronchomalacia in children. We consider this method to be safe, effective, repeatable, and reversible in small children with growing airways. As a time-buying procedure they can be especially useful in the treatment of tracheobronchomalacia.

Sections du résumé

BACKGROUND
Tracheobronchomalacia is the most common cause of congenital airway obstruction in infants. An alternative for surgical approach (aortopexy) can be metallic airway stents. Usually, they are not considered as a first choice because of the relatively high risk of complications. Recent years have brought encouraging reports of biodegradable stents applied in children.
OBJECTIVES
The aim of this study was to report our experience in the treatment of airway malacia using biodegradable stents.
MATERIAL AND METHODS
Six polydioxanone (PDS), self-expanding custom-made stents (ELLA-CS) were implanted in 2 children: 3 in the patient with left main bronchus occlusion due to postpnemonectomy syndrome and 3 stents in the baby with tracheomalacia.
RESULTS
Airway collapse was always relieved after stent expansion. Both patients needed repeated stenting because of limited stent lifespan. All the stents were implanted without complications through a rigid bronchoscope. The baby with stented main bronchus died because of irreversible lung lesion.
CONCLUSIONS
This small study shows that biodegradable airway stents seem to be an attractive option in the treatment of tracheobronchomalacia in children. We consider this method to be safe, effective, repeatable, and reversible in small children with growing airways. As a time-buying procedure they can be especially useful in the treatment of tracheobronchomalacia.

Identifiants

pubmed: 31199878
doi: 10.17219/acem/94391
doi:

Substances chimiques

Biocompatible Materials 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

961-965

Auteurs

Andrzej Zając (A)

Department of Pediatric Surgery, University Children's Hospital, Jagiellonian University, Poland.

Mirosław Krysta (M)

Department of Pediatric Surgery, University Children's Hospital, Jagiellonian University, Poland.

Aleksandra Kiszka (A)

Department of Pediatric Surgery, University Children's Hospital, Jagiellonian University, Poland.

Wojciech Górecki (W)

Department of Pediatric Surgery, University Children's Hospital, Jagiellonian University, Poland.

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