Biodegradable polydioxanone stents in the treatment of adult patients with tracheal narrowing
Jazyk angličtina Země Velká Británie, Anglie Médium electronic
Typ dokumentu klinická studie, časopisecké články, práce podpořená grantem
PubMed
26690793
PubMed Central
PMC4687362
DOI
10.1186/s12890-015-0160-6
PII: 10.1186/s12890-015-0160-6
Knihovny.cz E-zdroje
- MeSH
- biokompatibilní materiály chemie MeSH
- bronchoskopie MeSH
- lidé středního věku MeSH
- lidé MeSH
- polydioxanon chemie MeSH
- senioři MeSH
- stenóza průdušnice chirurgie MeSH
- stenty klasifikace MeSH
- trachea chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- biokompatibilní materiály MeSH
- polydioxanon MeSH
BACKGROUND: Biodegradable stents that disintegrate after a period of time are expected to be well tolerated and have advantages over other stents that are more commonly used in practice today. Polydioxanone is a biodegradable polymer that is widely used during surgery with absorbable sutures. METHODS: We present cases from the first four patients to undergo a tracheal polydioxanone stent insertion. Indications included significant non-malignant tracheal stenosis in cases where primary surgical treatment was not possible. The stents were implanted using rigid bronchoscopy and patients received regular follow-ups as needed. This use of biodegradable stents in adult patients was a novel, previously untested approach. The study was approved by the Institutional Ethics Committee and was based on a project entitled; "Biodegradable stents in the management of stenoses of large airways" (project NT 14146-3/2013). RESULTS: Six biodegradable stents were implanted in four patients with benign stenoses. No technical difficulties occurred and no serious or life-threatening events were recorded. All patients reported some benefit from treatment. CONCLUSION: Polydioxanone tracheal stents can be considered when a need for temporary support is expected, and as an alternative to other stents if the latter could compromise the patient. Owing to limited experience and observed disadvantages, further research is needed to fully assess this treatment. TRIAL REGISTRATION: This work is based on project NT14146 - Biodegradable stents in the management of stenoses of the large airways (2013-2015, MZ0/NT), registered from May 1, 2013 in The Research and Development and Innovation Information System of the Czech Republic and in ClinicalTrials.gov, reg. no. NCT02620319, December 2, 2015.
Department of Thoracic Surgery Thomayer Hospital Videnska 800 Prague 4 140 59 Czech Republic
ELLA CS Ltd Milady Horakove 504 45 Trebes 500 06 Hradec Kralove Czech Republic
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Chin CS, Litle V, Yun J, Weiser T, Swanson SJ. Airway stents. Ann Thorac Surg. 2008;85(2):792–796. doi: 10.1016/j.athoracsur.2007.11.051. PubMed DOI
Freitag L. Airway stents. In: Strausz J, Bolliger CT, editors. Interventional pulmonology. European Respiratory Monograph. Sheffield: European Respiratory Society, Publications Office. 2010;p. 190-217.
Dutau H, Maldonado F, Laroumagne S, Astoul P. Silicone stents, the rigid bronchoscope, and the standard of care in central airway stenosis. Curr Respir Care Rep. 2012;1:46–53. doi: 10.1007/s13665-011-0003-8. DOI
Lee P, Kupeli E, Mehta AC. Airway stents. Clin Chest Med. 2010;31:141–150. doi: 10.1016/j.ccm.2009.08.002. PubMed DOI
Saito Y, Minami K, Kaneda H, Okada T, Maniwa T, Araki Y, et al. New tubular bioabsorbable knitted airway stent - feasibility assessment for delivery and deployment in a dog model. Ann Thorac Surg. 2004;78:1438–1440. doi: 10.1016/S0003-4975(03)01408-5. PubMed DOI
Korpela A, Aarnio P, Sariola H, Törmälä P, Harjula A. Comparison of tissue reactions in the tracheal mucosa surrounding a bioabsorbable and silicone airway stents. Ann Thorac Surg. 1998;66:1772–1776. doi: 10.1016/S0003-4975(98)00763-2. PubMed DOI
Korpela A, Aarnio P, Sariola H, Törmälä P, Harjula A. Bioabsorbable self-reinforced poly-L-lactide, metallic and silicone stents in the management of experimental tracheal stenosis. Chest. 1999;115:490–495. doi: 10.1378/chest.115.2.490. PubMed DOI
Saito Y, Minami K, Kobayashi M, Nakao Y, Omiya H, Imamura H, et al. New tubular bioabsorbable knitted airway stent: biocompatibility and mechanical strength. J Thorac Cardiovasc Surg. 2002;123:161–167. doi: 10.1067/mtc.2002.118503. PubMed DOI
Zilberman M, Nelson KD, Eberhart RC. Mechanical properties and in vitro degradation fibers and expandable fiber-based stents. J Biomed Mater Res B Appl Biomater. 2005;74:792–799. doi: 10.1002/jbm.b.30319. PubMed DOI
Novotny L, Crha M, Rauser P, Hep A, Misik J, Necas A, et al. Novel biodegradable polydioxanone stents in a rabbit airway model. J Thorac Cardiovasc Surg. 2012;143:437–444. doi: 10.1016/j.jtcvs.2011.08.002. PubMed DOI
Robey TC, Välimaa T, Murphy HS, Tôrmâlâ P, Mooney DJ, Weatherly RA. Use of internal bioabsorbable PLGA “finger-type” stents in a rabbit tracheal reconstruction model. Arch Otolaryngol Head Neck Surg. 2000;126:985–991. doi: 10.1001/archotol.126.8.985. PubMed DOI
Tsukada H, Matsuda S, Inoue H, Ikada Y, Osada H. Comparison of bioabsorbable materials for use in artificial tracheal grafts. Interact Cardiovasc Thorac Surg. 2009;8:225–229. doi: 10.1510/icvts.2008.186528. PubMed DOI
Sewall GK, Warner T, Connor NP, Hartig GK. Comparison of resorbable poly-L-lactic acid-polyglycolic acid and internal Palmaz stents for the surgical correction of severe tracheomalacia. Ann Otol Rhinol Laryngol. 2003;112:515–521. doi: 10.1177/000348940311200606. PubMed DOI
Ng AH, Ng NS, Zhu GH, Lim LH, Venkatraman SS. A fully degradable tracheal stent: in vitro and in vivo characterization of material degradation. J Biomed Mater Res B Appl Biomater. 2012;100:693–699. doi: 10.1002/jbm.b.32501. PubMed DOI
Lischke R, Pozniak J, Vondrys D, Elliott MJ. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg. 2011;40:619–624. PubMed
Vondrys D1, Elliott MJ, McLaren CA, Noctor C, Roebuck DJ. First experience with biodegradable airway stents in children. Ann Thorac Surg. 2011;92(5):1870–1874. doi: 10.1016/j.athoracsur.2011.07.042. PubMed DOI
Antón-Pacheco JL, Comas JV, Luna C, Benavent MI, López M, Ramos V, et al. Treatment strategies in the management of severe complications following slide tracheoplasty in children. Eur J Cardiothorac Surg. 2014;46:280–285. doi: 10.1093/ejcts/ezt617. PubMed DOI
Serio P, Fainardi V, Leone R, Baggi R, Grisotto L, Biggeri A, et al. Tracheobronchial obstruction: follow-up study of 100 children treated with airway stenting. Eur J Cardiothorac Surg. 2014;45:100–109. doi: 10.1093/ejcts/ezt626. PubMed DOI
Hytych V, Horazdovsky P, Stehlik L, Pracharova S, Pohnan R, Lefnerova S, et al. Our own method of fixation of biodegradable tracheal stent. Bratisl Med J. 2015;116:34–342. PubMed
Biodegradable tracheal stents: our ten-year experience with adult patients
ClinicalTrials.gov
NCT02620319