Airway Stent Placement

What does an airway stent do?

Airway stents are tiny tubes made out of silicone, metal or a hybrid material. These tubes are designed to prop open the airway and keep it from becoming obstructed again.

A silicone stent can be used to treat:

• blockages caused by tumors
• non-cancerous blockages that cannot be operated on
• abnormal connections between the trachea and esophagus, called fistulae.

A metal stent can be used to treat:

• Advanced-stage cancerous tumors blocking the trachea or bronchi, the branches of the trachea that lead to the lungs
• Non-cancerous blockages that cannot be treated by any other methods.

Your doctor will select the stent that he or she thinks will help you the most.

How is a stent placed?

Silicone Stent Placement – A typical silicone stent is placed using a rigid bronchoscope, a long metal tube that allows your doctor to see down into your airway while you are under general anesthesia.²

Your doctor will insert the bronchoscope into your airway through your mouth. Your doctor may remove some of the tissue that is blocking your airway. The stent is then inserted and guided into position. Once in place, the stent is opened in your airway. Your doctor will then make sure the stent is in the proper position. If it is not, your doctor may reposition it using long graspers called forceps.^3,4

Metal Stent Placement – A typical metal stent is placed using a flexible bronchoscope.¹ A flexible bronchoscope is a long, steerable camera on a flexible operating catheter that can be inserted in your airway and help your doctor see. Flexible bronchoscopy can be performed using local anesthesia and with or without conscious sedation or general anesthesia.⁵ With conscious sedation, typically you are very sleepy but can be awakened if someone touches you.

After the bronchoscope is in place, a guidewire is then inserted through the bronchoscope through the obstruction in your airway. The bronchoscope is then removed. The stent is then moved along the guidewire until it is positioned in the right place in the airway. Once in position, the stent is opened.⁶

Are there any risks to the procedure?

As with any medical procedure, there are risks and you should talk to your doctor about what they are. Your doctor will be able to explain the risks and answer any questions you may have. Potential complications that can arise during a silicone stent procedure include damage to the surrounding tissue, pain, bleeding, or tissue perforation. Other potential complications include inhaling the stent into your lungs and not getting enough oxygen.

Potential complications that you may experience after a silicone stent placement include pain, bleeding, tissue perforation, and being able to feel the stent in your airway. There is also a chance that the stent may move out of place. You may also be susceptible to infection by bacteria or fungi, edema (the abnormal accumulation of fluid in tissue), fever, development of fistula (abnormal passages between two organs), and other serious infections.3,7 These potential complications are similar to those that may arise from other bronchoscopy procedures. However, should complications arise, your doctor may be able to remove the silicone stent.²

Potential complications that may be experienced with metal stents include stent misplacement, bleeding, tissue perforation, pain, inhaling the stent further into your lungs, infection or the stent being blocked by mucous. In some cases additional intervention is needed to get rid of tissue that may have grown through parts of the stent and is blocking the airway opening.⁶

Recovery Period

Recovery times may vary depending on the disease that is being treated. However, since a silicone stent placement procedure is performed under general anesthesia you will most likely need to spend a few days in the hospital. Because metallic stents are often placed using conscious sedation, the procedure may be conducted on an outpatient basis and you may only need to spend a few hours in the hospital.

This reference text contains information about a specific procedure and is provided by Boston Scientific Corporation for reference only. Please talk to your doctor about complete procedural information, potential risks, and questions you may have.

References

1. Bolliger CT, Mathur PN(eds): Interventional Bronchoscopy. Prog Respir Res. Basel, Karger, 2000, vol 30, pp 171-186.
2. Seijo L, Sterman, D. Interventional Pulmonology. New Eng J Med. 2001;344:740-749.
3. Wasserman K, Koch A, Muller-Ehmsen J, Reuter M, Michel O, Eckel HE. Clinical and laboratory evaluation of a new thin-walled self-expanding tracheobronchial silicone stent: progress and pitfalls. J Thorac Surg. 1997;114:527-532.
4. Vonk-Noordegraaf A, Postmus P, Sutedja T. Tracheobronchial stenting in the terminal care of cancer patients with central airways obstruction. Chest. 2001;120:1811-1814.
5. Ernst A, Silvestri G, Johnstone D. Interventional Pulmonary Procedures. Chest. 2003;123:1693-1717.
6. Saad C, Murthy S, Krizmanich G, Mehta A. Self-expandable metallic airway stents and flexible bronchoscopy. Chest. 2003;124:1993-1999.
7. Puma F, Farabi R, Urbani M, et al. Long-term safety and tolerance of silicone and self-expandable airway stents: an experimental study. Ann Thorac Surg. 2000;69:1030-1034.