Silicone Stent Versus Fully Covered Metallic Stent in Malignant Central Airway Stenosis
Date
2021
Type:
Article
item.page.extent
item.page.accessRights
item.contributor.advisor
ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
item.page.isbn
item.page.issn
item.page.issne
item.page.doiurl
item.page.other
item.page.references
Abstract
Background: Airway stenting to restore airway patency in cases of malignant central airway obstruction is an effective palliation treatment. Our goal was to compare the efficacy after deployment and complications of a fully covered self-expandable metal stent (SEMS) (Aerstent) and a silicone stent (Dumon).
Methods: This was a retrospective cohort of 2 similar groups of patients with malignant central airway obstruction treated with stents between August 2012 and July 2017. Complications were assessed bronchoscopically. A competing risk for death analysis was performed to adjust the probability of developing a complication.
Results: Seventy patients (29 with silicone stents and 41 with SEMS) were included. Stent insertion was successful in all cases. Mucus retention was the most frequent complication (75.9% with silicone stents and 84.8% with SEMS; P = .51), followed by granulation tissue (51.7% with silicone stents and 41.3% with SEMS; P = .52) and migration (6.9% with silicone stents and 13.0% with SEMS; P = .47). In the first month, the cumulative incidence of a complication was 36.7% for silicone stents and 41.3% for SEMS and increased to 90.0% and 97.8% after 6 months, respectively (hazard ratio = 1.66; P = .04). A competing risk for death analysis showed an adjusted hazard ratio of 1.41 (P = .49) indicating no differences in overall complications between stents.
Conclusions: Both stents were equally successful and safe. The incidence of complications increased over time to 90% at 6 months for both stents. The risk of overall complications was higher for SEMS; nevertheless, when mortality was measured in a competitive risk analysis, no differences were found between SEMS and silicone stents.
Description
item.page.coverage.spatial
item.page.sponsorship
Citation
Ortiz-Comino RM, Morales A, López-Lisbona R, Cubero N, Diez-Ferrer M, Tebé C, Rosell A; ESCODULE Study Group. Silicone Stent Versus Fully Covered Metallic Stent in Malignant Central Airway Stenosis. Ann Thorac Surg. 2021 Jan;111(1):283-289. doi: 10.1016/j.athoracsur.2020.04.141. Epub 2020 Jun 23. PMID: 32589886.
Keywords
Silicones, Stents, Adverse effects