AIRWAY STENTS - 08/09/11
Résumé |
A variety of palliative options are available for the management of large airway obstruction, selection dictated in large, by the nature of the obstruction, acuity of presentation, availability of a particular procedure, and the expertise of the bronchoscopist.12, 25, 50 As outlined in Figure 1, airway stents play a major role in the management of such clinical situations. The word stent honors a late nineteenth century British dentist, Charles R. Stent, who developed a dental impression material that was later used as a template to support healing skin grafts.47 Today, the word stent connotes to an artificial support that maintains patency of a hollow tubular structure. Although the concept of stenting can be traced back to the same period,6 it has only been in recent times that endobronchial stent placement has been regularly incorporated in clinical practice.
Over the last two decades, a large number of stents, with several design modifications, have surfaced in the market, the diversity attesting to ongoing pursuit of an ideal stent. The latter should possess several characteristics: (1) it should be easy to insert and remove, if necessary; (2) it should be available in different sizes to match the obstruction; (3) once placed can maintain its position without migration; (4) it should be firm enough to resist compressive forces, yet have sufficient elasticity to conform to the airway contours; (5) be made of inert material, not to irritate the airway, precipitate infection, or promote granulation tissue; and, (6) exhibit the same characteristics of the normal airway so that mobilization of secretions is not impaired. Obviously such a stent remains to be designed. In this article we provide an overview of present-day stents and present accumulated experience with Wallstents (Schneider Corporation, Minneapolis, MN), a type of stent that can be inserted using a flexible bronchoscope (FB).
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| Address reprint requests to Atul C. Mehta, MD, MBBS, FCCP, FACP, Department of Pulmonary and Critical Care Medicine, Desk A-90, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195 |
Vol 20 - N° 1
P. 139-151 - mars 1999 Retour au numéro
Article précédent
- CRYOTHERAPY, ELECTROCAUTERY, AND BRACHYTHERAPY
- Francis D. Sheski, Praveen N. Mathur
- ROLE OF BRONCHOSCOPY IN ASTHMA RESEARCH
- Mani S. Kavuru, Raed A. Dweik, Mary Jane Thomassen
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