David E Ost1, Archan M Shah2, Xiudong Lei3, Myrna C B Godoy4, Carlos A Jimenez2, George A Eapen2, Pushan Jani2, Andrew J Larson2, Mona G Sarkiss5, Rodolfo C Morice2. 1. Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: dost@mdanderson.org. 2. Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. 3. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX. 4. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX. 5. Department of Anesthesia, The University of Texas MD Anderson Cancer Center, Houston, TX.
Abstract
BACKGROUND: The most serious complications of airway stenting are long term, including infection and granulation tissue formation. However, to our knowledge, no studies have quantified the incidence rate of long-term complications for different stents. METHODS: To compare the incidence of complications of different airway stents, we conducted a retrospective cohort study of all patients at our institution who had airway stenting for malignant airway obstruction from January 2005 to August 2010. Patients were excluded if more than one type of stent was in place at the same time. Complications recorded were lower respiratory tract infections, stent migration, granulation tissue, mucus plugging requiring intervention, tumor overgrowth, and stent fracture. RESULTS: One hundred seventy-two patients with 195 stent procedures were included. Aero stents were associated with an increased risk of infection (hazard ratio [HR] = 1.98; 95% CI, 1.03-3.81; P = .041). Dumon silicone tube stents had an increased risk of migration (HR = 3.52; 95% CI, 1.41-8.82; P = .007). Silicone stents (HR = 3.32; 95% CI, 1.59-6.93; P = .001) and lower respiratory tract infections (HR = 5.69; 95% CI, 2.60-12.42; P < .001) increased the risk of granulation tissue. Lower respiratory tract infections were associated with decreased survival (HR = 1.57; 95% CI, 1.11-2.21; P = .011). CONCLUSIONS: Significant differences exist among airway stents in terms of infection, migration, and granulation tissue formation. These complications, in turn, are associated with significant morbidity and mortality. Granulation tissue formation develops because of repetitive motion trauma and infection.
BACKGROUND: The most serious complications of airway stenting are long term, including infection and granulation tissue formation. However, to our knowledge, no studies have quantified the incidence rate of long-term complications for different stents. METHODS: To compare the incidence of complications of different airway stents, we conducted a retrospective cohort study of all patients at our institution who had airway stenting for malignant airway obstruction from January 2005 to August 2010. Patients were excluded if more than one type of stent was in place at the same time. Complications recorded were lower respiratory tract infections, stent migration, granulation tissue, mucus plugging requiring intervention, tumor overgrowth, and stent fracture. RESULTS: One hundred seventy-two patients with 195 stent procedures were included. Aero stents were associated with an increased risk of infection (hazard ratio [HR] = 1.98; 95% CI, 1.03-3.81; P = .041). Dumon silicone tube stents had an increased risk of migration (HR = 3.52; 95% CI, 1.41-8.82; P = .007). Silicone stents (HR = 3.32; 95% CI, 1.59-6.93; P = .001) and lower respiratory tract infections (HR = 5.69; 95% CI, 2.60-12.42; P < .001) increased the risk of granulation tissue. Lower respiratory tract infections were associated with decreased survival (HR = 1.57; 95% CI, 1.11-2.21; P = .011). CONCLUSIONS: Significant differences exist among airway stents in terms of infection, migration, and granulation tissue formation. These complications, in turn, are associated with significant morbidity and mortality. Granulation tissue formation develops because of repetitive motion trauma and infection.
Authors: Alan R Burningham; Mark K Wax; Peter E Andersen; Edwin C Everts; James I Cohen Journal: Ann Otol Rhinol Laryngol Date: 2002-04 Impact factor: 1.547
Authors: David E Ost; Armin Ernst; Horiana B Grosu; Xiudong Lei; Javier Diaz-Mendoza; Mark Slade; Thomas R Gildea; Michael Machuzak; Carlos A Jimenez; Jennifer Toth; Kevin L Kovitz; Cynthia Ray; Sara Greenhill; Roberto F Casal; Francisco A Almeida; Momen Wahidi; George A Eapen; Lonny B Yarmus; Rodolfo C Morice; Sadia Benzaquen; Alain Tremblay; Michael Simoff Journal: Chest Date: 2015-08 Impact factor: 9.410
Authors: David E Ost; Armin Ernst; Horiana B Grosu; Xiudong Lei; Javier Diaz-Mendoza; Mark Slade; Thomas R Gildea; Michael S Machuzak; Carlos A Jimenez; Jennifer Toth; Kevin L Kovitz; Cynthia Ray; Sara Greenhill; Roberto F Casal; Francisco A Almeida; Momen M Wahidi; George A Eapen; David Feller-Kopman; Rodolfo C Morice; Sadia Benzaquen; Alain Tremblay; Michael Simoff Journal: Chest Date: 2015-05 Impact factor: 9.410
Authors: Horiana B Grosu; George A Eapen; Rodolfo C Morice; Carlos A Jimenez; Roberto F Casal; Francisco A Almeida; Mona G Sarkiss; David E Ost Journal: Chest Date: 2013-08 Impact factor: 9.410