Endobronchial prosthesis

Abstract

Airway stents have been consistently shown to help patients suffering from central airway obstruction and esophagorespiratory fistulas, by improving their quality of life and potentially survival. These prostheses, however, are foreign objects within the airways and adverse events are expected. The incidence rate of these events depends on patient-related factors and on specific stent-tissue interactions. Stent insertion is generally reserved for patients for whom curative open surgical interventions are not feasible or contraindicated. Metallic stents should be avoided in benign disease unless surgery or silicone stent placement is not possible. For malignant disease, stents are usually placed with a palliative intent and should be inserted to offer comfort without harming the terminally ill patient; therefore, they should be placed by operators who are able to manage both intraoperative, short-term and long-term complications after a careful analysis of expected benefits. Long-term stent-related complications are not uncommon and can occasionally be fatal. Since not all stents are equivalent in terms of biomechanics and stent-tissue interactions, manufacturers should probably describe these properties including the resistance to angulation, expansile force, and mechanical failure, not only to assure restoration of airway patency after insertion but also to potentially predict immediate and long-term stent-related complications.