Cross-linked hyaluronan-coated stents in the prevention of airway stenosis.
OBJECTIVE
This project studies the use of airway stents coated with a cross-linked derivative of hyaluronan (HA) in a rabbit airway model of subglottic stenosis (SGS).


METHODS
An acute subglottic mucosal injury and airway stent placement design were used in a rabbit model. Thirty-six rabbits were randomized to 6 different study groups. Four groups had the subglottic mucosa denuded at the cricoid, and 2 groups received no injury. Airway stents coated with Carbylan-SX, a cross-linked derivative of HA, and controls were placed for 3 weeks. After sacrifice at 6 weeks, morphometric measurements of subglottic lumen were taken.


RESULTS
In posttraumatic models, no significant differences were seen in airway area measures between groups (P = 0.86). In non-injury groups, a significant difference between Carbylan-SX versus non-HA-derivative-coated stents was seen (P = 0.05).


CONCLUSIONS
In this model of acute subglottic mucosal injury, the HA-derivative-coated stent did not improve healing. However, in the absence of mucosal injury, the Carbylan-SX film-coated stent yielded significantly larger airway areas compared with a noncoated stent.


CONCLUSIONS
Stents or endotracheal tubes coated with a cross-linked derivative of HA may prevent stenosis in patients without airway injury but require long-term intubation or laryngotracheal stenting.
Sondrup
Cole
C
University of Utah School of Medicine, The University of Utah, 50 N. Medical Drive, Salt Lake City, UT 84132, USA.
Liu
Yanchun
Y
Shu
Xiao Zheng
XZ
Prestwich
Glenn D
GD
Smith
Marshall E
ME
D000208:Acute Disease; D000276:Adjuvants, Immunologic / Q000494:pharmacology*; D000402:Airway Obstruction / Q000473:pathology / Q000517:prevention & control*; D000818:Animals; D020099:Coated Materials, Biocompatible; D003432:Cross-Linking Reagents / Q000494:pharmacology*; D004195:Disease Models, Animal; D005260:Female; D005500:Follow-Up Studies; D006820:Hyaluronic Acid / Q000494:pharmacology*; D007828:Laryngoscopy; D019919:Prosthesis Implantation / Q000295:instrumentation*; D011817:Rabbits; D015607:Stents; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D020099:Coated Materials, Biocompatible; D003432:Cross-Linking Reagents; D006820:Hyaluronic Acid