Table 3.
Stents-related contents and clinical results.
| Study | Number of stents used | Indications of stent-planting (n) | Right bronchial system complications (n) | Stent complications | Complication rate | Clinical results |
|---|---|---|---|---|---|---|
| 1 | 36 | All DAS | Right upper lobe 2 | Migration | 80% (4/5 patients) | No improvement in lung function |
| Right middle lobe 1 | Granulation tissue | No reduction in bronchoscopies per month | ||||
| Right lower lobe 1 | Mucous plugging | No difference in airway patency for stented patients | ||||
| Bronchus intermedius 2 | ||||||
| 2 | 27 | BM 9 | Right main stem bronchus 3 | Granulation tissue migration | 4.9% (per patient per mont) | 84% of the patients experienced immediate relief from dyspnea. |
| BS 12 | Right main stem bronchus 6 | Infection hemoptysis | The mean percentage change in FEV1 was significantly greater than zero at 1 and 6 months (P < 0.05) post-stent placement. | |||
| AD 3 | NA | Collapse | FVC is marginally improved for 6 months (P > 0.05). | |||
| Changes of FEV1 are marginal and may return to base line at 12 months | ||||||
| 3 | NA | CAS 19 | Right anastomosis 8 | Granulation tissue | NA | A significant increase in FEV1, FVC and FEV1/FVC ratio after therapy. |
| DAS 3 | Right anastomosis 3 | Stent fracture with wires protrusion | Airway patency and symptom improvement were achieved in 18 of 20 patients. | |||
| Stent erosion through the airway | 16 of 20 patients were able to have their stents removed at a mean of 362.3 ± 126.4 days with permanent resolution of airway stenosis. | |||||
| Longitudinal stent collapse | Overall survival was similar for patients with and without airway stenosis. | |||||
| Stent removal | ||||||
| 4 | 47 | AD 6 | NA | Mucous plugging | NA | Improvement in FEV1 after stent placement was only observed in patients who ultimately were able to undergo stent removal. |
| Cicatrix 19 | Granulation tissue | A statistically significant reduction in number of bronchoscopies per month after stent removal compared to pre-stent placement. | ||||
| Pseudomembrane 14 | ||||||
| BM 19 | ||||||
| 5 | NA | BS 18 | Right anastomosis 7 | Obstructive granulomas | 13% (per patient per month) | Symptomatic improvement was noted in all patients, and FEV1 increased significantly after stent insertion. |
| BM 2 | Right anastomosis 1 | Mucus plugging | Definitive stent removal in 12 of 17 (70.6%) patients without recurrence | |||
| BS+BM 3 | Right anastomosis 1 | Migration | Overall survival was similar | |||
| 6 | 49 | BS 12 | Right anastomosis 4 | Granulation tissue | Similar to those previously reported for silicone and metal stent. | The average degree of stenosis decreased from 80 to 20%. |
| AD 5 | Right anastomosis 4 | Migration | FEV1 and FVC increased significantly after stent insertion. | |||
| BM 12 | Right anastomosis 6 | Stent fracture | ||||
| BM+BS 20 | Right anastomosis 5 | Thick mucus formation | ||||
| 7 | 63 | BS 63 | NA | Severe purulent secretion Endobronchial bleeding Unscheduled bronchoscopy | A | A significant increase in the mean FEV1 60 days after stent insertion in the intervention group. |
| Stent collapse Stent pressure ulcer Polyps in stent Stent fractures | The FEV1 values were significantly lower in the intervention than in the control group at 2.5 years of post-transplantation | |||||
| Stent malposition Migration Necrosis | The mean FEV1 values did not differ significantly between the intervention and control groups at 5, 7.5, and 10 years. | |||||
| 8 | 60 | CAS 58 | Right anastomosis 28 | Granulation tissue Restenosis | NA | Provide immediate improvement in symptoms and pulmonary function tests in most cases. |
| DAS 2 | Fever | Mortality is similar to patients without stent insertion. | ||||
| 9 | 15 | BS 7 | Right main bronchus 3 | Bacterial bronchitis | 4% (per patient per month) | A non-statistically significant trend toward improvement was observed in FEV1. |
| AD 2 | Bronchus intermedius 1 Right main bronchus 1 | Obstructive granulomas | The overall 5-year survival rate for patients with SEMSs was similar compared with others. | |||
| BM 6 | Bronchus intermedius 1 | Stent insertion before day 90 proved to be an independent covariate associated with re-stenosis. | ||||
| 10 | 111 | BS* | Overall right bronchus 72 | Mucus plugging. | 80% | 27 (41.5%) patients developed BOS at 853 (104–1848) days after stent insertion. |
| AD* | Restenosis | Overall survival was significantly lower in recipients with SEMS than the total cohort | ||||
| Bacterial colonization | BOS-free survival was not affected. | |||||
| Hemoptysis | ||||||
| Stent fracture | ||||||
| Atelectasis | ||||||
| 11 | 32 | BS 32 | Right main bronchus 5 | Mucous plugging | Common | Symptoms were relieved and FEV1 increased in all patients. |
| Bronchus intermedius 7 | Granulation tissue | 25 stents in 21 patients were removed after 6 months (median). 22 of the stented airways remained patent and lung function were stable during the 24 months. | ||||
| Migration | The mean percentage change in FEV1 was 43 ± 44% (−30 to +100) | |||||
| 12 | 10 | BS 2 | Right main bronchus 2 | Stent dehiscence | Rare | The mean percentage change in FVC was 17 ± 24% (−15 to +57) |
| BM 2 | Bronchus intermedius 1 Right lower lobe 1 | Stent collapse | ||||
| BS+BM 2 | Right main bronchus 1 | |||||
| 13 | 20 | CAS 9 | NA | Perianastomotic necrosis of the bronchus | NA | The stenosis was initially relieved in all cases. |
| DAS 7 | Stenosis | There was no bleeding, perforation or displacement after BD stent implantation. | ||||
| BM 4 | Expectoration of small stent particles | Four patients needed multiple stenting for anastomotic re-stenosis. | ||||
| 14 | 50 | BS† | A | Stent fracture | 26% | Reduced pulmonary infection rates for up to 1 year after their insertion. |
| BM† | Liatrogenically damaged | Improvements in lung function | ||||
| Collapse | ||||||
| Obstruction | ||||||
| 15 | 28 | BS 23 | Right main bronchus 15 Bronchus intermedius 2 | Granulomas | 26% | Immediate symptomatic and functional improvement. |
| BM 5 | NA | Partial fibrosis stenosis | Improved FEV1, FVC, FEF50% | |||
| Hemoptysis | ||||||
| Stent broke | ||||||
| 16 | 11 | BS 3 | Right main bronchus + Bronchus intermedius 3 | Granulation | 10% | Functional improvement was immediate with a 35% mean FEV1 gain |
| BM 3 | NA | Previous recurrent episodes of pneumonia symptoms did not occur again | ||||
| BS + BM 5 | Right main bronchus 5 | |||||
| 17 | 11 | BS 11 | Right anastomosis 3 | Infection | 33.40% | All patients had increased lung function |
| Colonization | ||||||
| Accumulation of secretions |
NA, not available; BOS, bronchiolitis obliterans syndrome; DAS, distal airway strictures; CAS, central airway strictures; BS, bronchial stenosis; BM, bronchomalacia; AD, anastomotic dehiscence.
*The number of stents for BS or AD respectively is unavailable.
†The number of stents for BS or BM respectively is unavailable.