Treatment of complex airway stenoses using patient-specific 3D-engineered stents: a proof-of-concept study. Issue 8 (3rd April 2019)

• Record Type: Journal Article
• Authors: Guibert, Nicolas; Didier, Alain; Moreno, Benjamin; Lepage, Benoit; Leyx, Pierre; Plat, Gavin; Mhanna, Laurent; Murris, Marlene; Mazières, Julien; Hermant, Christophe
• Is Part Of: Thorax. Volume 74:Issue 8(2019)
• Page Start: 810
• Page End: 813
• Publication Date: 2019-04-03
• Subjects: bronchoscopy -- lung transplantation; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2018-212732
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Anatomically complex airway stenosis (ACAS) represents a challenging situation in which commercially available stents often result in migration or granulation tissue reaction due to poor congruence. This proof-of-concept clinical trial investigated the feasibility and safety of computer-assisted designed (CAD) and manufactured personalised three-dimensional (3D) stents in patients with ACAS from various origins. After CAD of a virtual stent from a CT scan, a mould is manufactured using a 3D computer numerical control machine, from which a medical-grade silicone stent is made. Complication rate, dyspnoea, quality of life and respiratory function were followed after implantation. The congruence of the stent was assessed peroperatively and at 1 week postimplantation (CT scan). The stent could be implanted in all 10 patients. The 3-month complication rate was 40%, including one benign mucus plugging, one stent removal due to intense cough and two stent migrations. 9 of 10 stents showed great congruence within the airways, and 8 of 10 induced significant improvement in dyspnoea, quality of life and respiratory function. These promising outcomes in highly complex situations support further investigation on the subject, including technological improvements.​ Trial registration number: NCT02889029 .