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(Chest. 2006;130:1419-1423.)
© 2006 American College of Chest Physicians

Performance of a Self-Expanding Silicone Stent in Palliation of Benign Airway Conditions*

Thomas R. Gildea, MD, FCCP; Sudish C. Murthy, MD, PhD, FCCP; Debashish Sahoo, MD; David P. Mason, MD and Atul C. Mehta, MBBS, FCCP

* From the Departments of Pulmonary, Allergy & Critical Care Medicine (Drs. Gildea, Sahoo, and Mehta) and Cardiothoracic Surgery (Drs. Murthy and Mason), Cleveland Clinic Foundation, Cleveland, OH.

Correspondence to: Atul C. Mehta, MBBS, FCCP, Medical Director-Lung Transplantation, Head Section of Bronchology, Vice-Chairman, Department of Pulmonary Allergy & Critical Care Medicine, The Cleveland Clinic Foundation, 9500 Euclid Ave, A-90, Cleveland, OH 44195; e-mail: mehtaa1{at}ccf.org

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.

Key Words: central airway obstruction • lung transplantation • Polyflex stent • silicone stent






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