A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs

Abstract

Background: Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome. Objectives: Determine the overall prevalence of complications of tracheal stenting in dogs. Methods: A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta-analyses were used to estimate pooled complications prevalence. Results: Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%–100%, late: 75%; 95% CI: 63%–85%, and clinically relevant: 52%; 95% CI: 42%–61%), tracheobronchial infections (24%; 95% CI: 14%–35%), and granulomas (20%; 95% CI: 11%–30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%–20%), relapsing collapse (10%; 95% CI: 5%–15%), and stent migration (5%; 95% CI: 1%–9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough. Conclusions and Clinical Importance: Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second-line procedure that does not necessarily alleviate the need for medical treatment and frequent follow-up visits. Additional studies are warranted to identify the risk factors of these complications.