Using individualized three-dimensional printed airway models to guide airway stent implantation. (5th November 2020)

• Record Type: Journal Article
• Authors: Xu, Jesse; Sullivan, Cameron; Ong, Hui Xin; Williamson, Jonathan P; Traini, Daniela; Hersch, Nicole; Byrom, Michael; Young, Paul M
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 31:Number 6(2020)
• Page Start: 900
• Page End: 903
• Publication Date: 2020-11-05
• Subjects: Airway stents -- 3D printing -- Tracheobronchomalacia -- Excessive dynamic airway collapse -- Airway model -- Personalization -- Stent fenestrations; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivaa206
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: Airway stents are used to manage central airway obstructions by restoring airway patency. Current manufactured stents are limited in shape and size, which pose issues in stent fenestrations needed to be manually created to allow collateral ventilation to airway branches. The precise location to place these fenestrations can be difficult to predict based on 2-dimensional computed tomography images. Inspiratory computed tomography scans were obtained from 3 patients and analysed using 3D-Slicer™, Blender™ and AutoDesk ® Meshmixer™ programmes to obtain working 3D-airway models, which were 3D printed. Stent customizations were made based on 3D-model dimensions, and fenestrations into the stent were cut. The modified stents were then inserted as per usual technique. Two patients reported improved airway performance; however, stents were later removed due to symptoms related to in-stent sputum retention. In a third patient, the stent was removed a few weeks later due to the persistence of fistula leakage. The use of a 3D-printed personalized airway model allowed for more precise stent customization, optimizing stent fit and allowing for cross-ventilation of branching airways. We determine that an airway model is a beneficial tool for stent optimization but does not prevent the development of some stent-related complications such as airway secretions. Abstract : Airway stents are used clinically to restore airway patency for symptom control in those suffering from central airway obstruction (CAO) and have a moderate success rate, with most studies reporting a 20–69% failure rate within 6 months of insertion [1].