title: Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse.
abstract: BACKGROUND
  Patients with severe symptomatic expiratory central airway collapse (ECAC) undergo a stent trial to determine whether they are candidate for tracheobronchoplasty. Most stent trials were done using silicone stents. However, there was a higher number of silicone stent-related complications.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of short-term uncovered self-expanding metallic airway stents (USEMAS) in patients with ECAC.
  
  
  METHODS
  This was a retrospective review. Baseline measurements were compared to those obtained after 7-14 days. Measurements included: Modified Medical Research Council (mMRC), Cough Quality of Life Questionnaire (CQLQ), spirometry testing, and 6-Minute Walk Test (6MWT). Stent- and procedure-related complications were reported.
  
  
  RESULTS
  33 patients (median age, 52 years) underwent the USEMAS trial. Presenting symptoms were dyspnea in 100%, intractable cough in 90.3%, recurrent infection in 42.2%, and inability to clear secretions in 21.4%. Dyspnea, cough, and secretion clearance improved in 88, 70, and 57%, respectively. Overall, there was a significant improvement in mMRC (p < 0.001), CQLQ (p = 0.015), and 6MWT (p = 0.015). There was 1 airway infection, 1 stent migration, and 1 pneumothorax. The median duration of USEMAS was 7 days. All stents were removed without any complications. At the time of stent removal, no granulation tissue was observed in 30.9%, and mild granulation tissue was observed in 69.1%.
  
  
  CONCLUSIONS
  The short-term USEMAS trial improves respiratory symptoms, quality of life, and exercise capacity with few complications in patients with severe symptomatic ECAC when performed by a multidisciplinary airway team in highly specialized centers with experience in the evaluation and treatment of this patient population.
authors: Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors: Adnan
authors: A
authors: Majid
authors: Daniel
authors: D
authors: Alape
authors: Fayez
authors: F
authors: Kheir
authors: Erik
authors: E
authors: Folch
authors: Sebastian
authors: S
authors: Ochoa
authors: Alejandro
authors: A
authors: Folch
authors: Sidhu P
authors: SP
authors: Gangadharan
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D001999:Bronchoscopy; D016208:Databases, Factual; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D012720:Severity of Illness Index; D012828:Silicones; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055089:Tracheobronchomalacia / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D012828:Silicones