title: Fully covered self-expandable metal stent in tracheobronchial disorders: clinical experience.
abstract: BACKGROUND
  The third-generation fully covered self-expandable metallic stent (SEMS) has been developed to solve the problems of difficult removal and in-stent granuloma formation related to the uncovered or partially covered type. There are few written reports about the performance of this type of stents with early encouraging results.
  
  
  OBJECTIVE
  To report and analyse our experience with the Silmet® stent in the management of malignant and benign tracheobronchial disorders.
  
  
  METHODS
  We retrospectively reviewed medical records of patients who underwent fully covered SEMS Silmet placement at the Interventional Pulmonology Unit, La Maddalena Cancer Center, Palermo, Italy, between May 2010 and August 2013.
  
  
  RESULTS
  Stents were placed in 52 patients with malignant (n = 49) and benign airway obstruction (n = 2) and broncho-oesophageal fistula (n = 1). SEMSs were inserted into the trachea (n = 19), the main bronchi (n = 21) and the peripheral bronchi (n = 31). Besides 1 procedural dislocation, the deployment was successful in all patients with an immediate significant improvement of symptoms (Barthel Index p < 0.001; Medical Research Council score p < 0.001). A radiographic improvement was detected in 48% of patients. The mean follow-up duration was 119 ± 120 days (range 22-549 days). Complications observed were: migration (7.6%), tumour overgrowth (15%), infections (5.7%), granulation tissue formation (3.8%) and mucus plug (3.8%).
  
  
  CONCLUSIONS
  The Silmet stent is effective, safe and simple to implant and remove. We suggest its use in cases of tight stenoses, in the treatment of small- to medium-caliber airways or in cases of tortuous airways.
authors.affiliation: Interventional Pulmonology Unit, La Maddalena Cancer Center, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marchese
authors.forename: Grazia
authors.initials: G
authors.lastname: Poidomani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paglino
authors.forename: Claudia
authors.initials: C
authors.lastname: Crimi
authors.forename: Chiara
authors.initials: C
authors.lastname: Lo Nigro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Argano
mesh_terms: D000368:Aged; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D055752:Small Cell Lung Carcinoma / Q000150:complications; D014135:Tracheal Stenosis / Q000209:etiology / Q000628:therapy*