Novel Stening® conical airway silicone stent: First experience in central airway stenosis

Abstract

Introduction: Airway stenting is a treatment option for benign or malignant airway stenosis. Generally, nitinol stents are most frequently used due to easier and faster application compared to silicone stents. However, nitinol stents are associated with a higher risk of local complications.

Objectives: To describe the first experience on a novel conical silicone airway stent model (Stening®, Silicone Airway Device, CLASSX) including our established insertion technique and patient outcome.

Methods: Since 09/2019, we identified n=6 patients undergoing airway stenting using the above mentioned device. Following rigid intubation (tracheoscopre, 14 mm) and dilatation of the stenosis, the stent was threaded onto a pulmonary balloon dilatation catheter (Boston Scientific) and thereby placed in front of the stenosis. Using a smaller rigid bronchoscope (6,5 mm) the conical designed stent was pushed into the stenosis guided by the dilatation catheter under fluoroscopy. A passage of the stenosis by the rigid bronchoscope was not necessesary.

Results: The selected patients suffered from either benign (n=1) or malignant (n=5) airway stenosis. In one patient, stent insertion had to be aborted because placement in the left lower lobe bronchus was technically not feasible. Mean duration of procedure was 30 minutes. Follow-up bronchoscopies revealed permanent correct position without evidence of local complications. All patients were discharged in between 1-4 days following intervention (median 1 day). The median overall survival was 248 (95% CI, 92 – 404) days.

Conclusions: In our experience, the CLASSX Stent insertion in central airway stenosis is considered a safe and feasable alternative to self expanding devices.