Airway Stenting in Benign and Malignant Diseases
Pp. 196-214 (19)
David P. Breen and Mohammed Ahmed
Airway stenting is an important technique for the treatment of central airway
obstruction and is a major component of an integrated Interventional Pulmonology
service. Indications for this intervention can be broadly divided into malignant and
benign conditions. Malignant airway obstruction is the commonest indication and can
happen due to endobronchial tumors or external compression. Benign conditions
include stenosis, fistula and airway malacia. An important consideration in benign
conditions is patient longevity. Two groups of stents are available- silicon and metallic.
Each is associated with advantages and disadvantages and the choice of stents depends
on a number of factors including airway and disease related factors, physician choice
and expertise and the available equipment within the endoscopy unit. Silicone stents
require rigid bronchoscopy for placement while metallic stents can be deployed using
flexible bronchoscopy. Irrespective of prosthesis type, stent related complications occur
and include migration, stent obstruction from mucus, tumor ingrowth or granulation
tissue and stent fracture. Finally, novel drug eluting and biodegradable stents are being
studied with promising early results.
airway, bronchoscopy, fistula, malacia, malignant, metallic, silicone,
Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland.