OBJECTIVE: This study was undertaken to evaluate safety and biocompatibility of a novel biodegradable polydioxanone stent in a rabbit tracheal model. Metallic and silicone stents represent standard therapeutic approaches for hollow organ stenosis, although complications have been reported repeatedly. Biodegradable stents could reduce the risks associated with this procedure while still achieving the purpose of maintaining lumen patency. METHODS: A commercially available polydioxanone suture strand with a long safety record was used to manufacture the self-expanding stents. The polydioxanone stents were then implanted bronchoscopically and under fluoroscopic guidance into the tracheas of white rabbits (N = 25). Periodic clinical examination was performed. Histopathologic examination concluded the study for the 5 experimental groups at 3, 4, 5, 10, and 15 weeks after implantation. RESULTS: There were no unexpected deaths and no stent displacements during the study. The animals remained in good condition, without stent debris expectoration. Macroscopic examination revealed that the tracheal lumen stayed open. Histologic examination showed that tracheal damage score was highest 5 weeks after stenting, including in-stent necrosis of the epithelium. Stent degradation was complete with no remnants after 10 weeks, leaving the trachea completely healed at 15 weeks after implantation. CONCLUSIONS: This animal airway model has demonstrated acceptable safety and biocompatibility of this novel biodegradable polydioxanone stent. We suggest that polydioxanone stenting be used for further clinical studies for cases in which complete stent degradation after temporary airway treatment is desirable.
- MeSH
- bronchoskopie škodlivé účinky přístrojové vybavení MeSH
- časové faktory MeSH
- fluoroskopie MeSH
- intervenční radiografie metody MeSH
- králíci MeSH
- modely u zvířat MeSH
- polydioxanon MeSH
- protézy - design MeSH
- stenty MeSH
- testování materiálů MeSH
- trachea patologie radiografie chirurgie MeSH
- vstřebatelné implantáty MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To evaluate the safety and effectiveness of novel biodegradable (BD) stents to treat bronchial anastomotic stenosis in patients after lung transplantation. METHODS: Twenty BD stents were implanted endoscopically in six patients (median age 41.5 years (range 35-57 years)) with post-transplant bronchial anastomotic stenoses, between 2006 and 2010. All stents were custom-made from bio-absorbable polydioxanone (PDS). The median stent diameter was 12 mm (8-17 mm) and median length was 20mm (12-30 mm). All patients were evaluated clinically, by bronchoscopy and high-definition computed tomography (CT). RESULTS: The stenosis was initially relieved in all cases. There was no bleeding, perforation or displacement after BD stent implantation. Four patients needed multiple stenting for anastomotic re-stenosis. Median time to any re-stenting was 5 months (2-15 months). There was one sudden death, 1 year after the last BD stent implantation, from a pulmonary embolus. All five survivors are in good clinical condition up to 4 years' follow-up (median 40 months, range 7-48 months) since first stenting and intervention-free up to 44 months (median 24 months, range 7-44 months). CONCLUSIONS: This small pilot study shows that BD stents are a safe, effective and reliable alternative to classical metallic stents in patients with anastomotic stenosis after lung transplantation, and may avoid the need for permanent stenting.
- MeSH
- anastomóza chirurgická škodlivé účinky MeSH
- bronchiální nemoci etiologie chirurgie MeSH
- bronchoskopie MeSH
- dospělí MeSH
- epidemiologické metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- obstrukce dýchacích cest etiologie chirurgie MeSH
- polydioxanon MeSH
- protézy - design MeSH
- stenóza etiologie chirurgie MeSH
- stenty MeSH
- transplantace plic škodlivé účinky MeSH
- vstřebatelné implantáty MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Přeruš. str. : il., tab. ; 32 cm
Syndrom hypoplastického levého srdce je kritická vrozená srdeční vada, dosud u nás neoperovatelná. Vada se vyskytuje v širokém spektru změn levé komory, mitrální a aortální chlopně a aorty. Cílem projektu je morfologická studie preparátů srdce s hypoplastickým levým srdcem se zaměřením na struktury důležité z hlediska Norwoodovy operace. Nálezy budeme korelovat s klinickým a echografickým nálezem.; The hypoplastic left heart syndrome represents a critical congenital heart lesion, considered to be inoperable in our country. The lesion cal occur in a wide spectrum of changes of the left ventricle, mitral and aortic valve and aorta. In some centres athree-step palliative surgical management was established. The first surgery (Norwood procedure) must be performed in a neonate. Surgical results depend on the heart morphology.
- Konspekt
- Lékařské vědy. Lékařství
- NLK Obory
- kardiologie
- chirurgie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
