Update in airway stents.
OBJECTIVE
Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population.


RESULTS
Airway stenting is highly effective in palliating symptoms of airway obstruction. There are several types of stents available with different advantages and disadvantages depending mainly on the material they are made from. Clinical outcomes seem to be comparable between silicone and self-expanding metal stents. Self-expanding metal stents have proven to be efficient in recanalizing 'complex' central airway obstructions. Preliminary data show that a new self-expanding 'hybrid' stent appears to be effective and safe for malignant airway obstruction. Airway stent complications vary according to the type of stent and the type of obstruction. Multidetector computed tomography seems to be a valuable adjunct to bronchoscopy in detecting and characterizing stent complications. A clear definition of airway stent-related infection is urgently needed to provide adequate diagnosis and management of this complication. Metal stent fracture is less common in patients with malignant airway obstruction as compared with benign disease, and this could be partially explained by the decreased survival and shorter exposure to stent in the former population.


CONCLUSIONS
Airway stents are of great help in palliating symptoms of malignant central airway obstruction. Unfortunately, there have been no recent striking advances in stent technology and the ideal stent has yet to be designed.
Department of Pulmonary and Critical Care Medicine, Michael E DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA. casal@bcm.edu
Roberto F
RF
Casal
D000402:Airway Obstruction / Q000209:etiology* / Q000517:prevention & control*; D001999:Bronchoscopy; D003952:Diagnostic Imaging; D006801:Humans; D010166:Palliative Care; D018579:Patient Selection; D012142:Respiratory Tract Neoplasms / Q000150:complications; D015607:Stents / Q000009:adverse effects