Airway stabilization with silicone stents for treating adult tracheobronchomalacia: A prospective observational study

Armin Ernst*, Adnan Majid, David Feller-Kopman, Jorge Guerrero, Phillip Boiselle, Stephen H. Loring, Carl O'Donnell, Malcolm DeCamp, Felix J F Herth, Sidhu Gangadharan, Simon Ashiku

*Corresponding author for this work

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

Rationale: It is postulated that in patients with severe tracheobronchomalacia (TBM), airway stabilization with stents may relieve symptoms. Objectives: To evaluate the effect of silicone stents (tracheal, mainstem bronchus, or both) on symptoms, quality of life, lung function, and exercise capacity in these patients. Methods: A prospective observational study in which baseline measurements were compared to those obtained 10 to 14 days after stent placement. Measurements and main results: Of 75 referred patients, 58 had severe disease and underwent therapeutic rigid bronchoscopy with stent placement. Mean age was 69 years (range, 39 to 91 years), 34 were men, 33 had COPD, and 13 had asthma. Almost all patients (n = 57) had dyspnea as a sole symptom or in combination with cough and recurrent infections; four patients required mechanical ventilation for respiratory failure. In 45 of 58 patients, there was reported symptomatic improvement; quality of life scores improved in 19 of 27 patients (p = 0.002); dyspnea scores improved in 22 of 24 patients (p = 0.001); functional status scores improved in 18 of 26 patients (p = 0.002); and mean exercise capacity improved from baseline, although not significantly. The 49 complications included mainly 21 partial stent obstructions, 14 infections, and 10 stent migrations. Most patients with concomitant COPD also improved on most measures. Conclusions: In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status. Coexisting COPD is not an absolute contraindication to a stenting trial in this population. Stenting is associated with a high number of short-term and long-term but generally reversible complications.

Original languageEnglish (US)
Pages (from-to)609-616
Number of pages8
JournalChest
Volume132
Issue number2
DOIs
StatePublished - Jan 1 2007

Fingerprint

Tracheobronchomalacia
Silicones
Stents
Observational Studies
Prospective Studies
Chronic Obstructive Pulmonary Disease
Quality of Life
Dyspnea
Exercise
Bronchoscopy
Bronchi
Infection
Artificial Respiration
Cough
Respiratory Insufficiency

Keywords

  • Airway stabilization
  • Bronchoscopy
  • COPD
  • Stent placement
  • Tracheobronchomalacia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ernst, A., Majid, A., Feller-Kopman, D., Guerrero, J., Boiselle, P., Loring, S. H., ... Ashiku, S. (2007). Airway stabilization with silicone stents for treating adult tracheobronchomalacia: A prospective observational study. Chest, 132(2), 609-616. https://doi.org/10.1378/chest.06-2708
Ernst, Armin ; Majid, Adnan ; Feller-Kopman, David ; Guerrero, Jorge ; Boiselle, Phillip ; Loring, Stephen H. ; O'Donnell, Carl ; DeCamp, Malcolm ; Herth, Felix J F ; Gangadharan, Sidhu ; Ashiku, Simon. / Airway stabilization with silicone stents for treating adult tracheobronchomalacia : A prospective observational study. In: Chest. 2007 ; Vol. 132, No. 2. pp. 609-616.
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abstract = "Rationale: It is postulated that in patients with severe tracheobronchomalacia (TBM), airway stabilization with stents may relieve symptoms. Objectives: To evaluate the effect of silicone stents (tracheal, mainstem bronchus, or both) on symptoms, quality of life, lung function, and exercise capacity in these patients. Methods: A prospective observational study in which baseline measurements were compared to those obtained 10 to 14 days after stent placement. Measurements and main results: Of 75 referred patients, 58 had severe disease and underwent therapeutic rigid bronchoscopy with stent placement. Mean age was 69 years (range, 39 to 91 years), 34 were men, 33 had COPD, and 13 had asthma. Almost all patients (n = 57) had dyspnea as a sole symptom or in combination with cough and recurrent infections; four patients required mechanical ventilation for respiratory failure. In 45 of 58 patients, there was reported symptomatic improvement; quality of life scores improved in 19 of 27 patients (p = 0.002); dyspnea scores improved in 22 of 24 patients (p = 0.001); functional status scores improved in 18 of 26 patients (p = 0.002); and mean exercise capacity improved from baseline, although not significantly. The 49 complications included mainly 21 partial stent obstructions, 14 infections, and 10 stent migrations. Most patients with concomitant COPD also improved on most measures. Conclusions: In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status. Coexisting COPD is not an absolute contraindication to a stenting trial in this population. Stenting is associated with a high number of short-term and long-term but generally reversible complications.",
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Ernst, A, Majid, A, Feller-Kopman, D, Guerrero, J, Boiselle, P, Loring, SH, O'Donnell, C, DeCamp, M, Herth, FJF, Gangadharan, S & Ashiku, S 2007, 'Airway stabilization with silicone stents for treating adult tracheobronchomalacia: A prospective observational study', Chest, vol. 132, no. 2, pp. 609-616. https://doi.org/10.1378/chest.06-2708

Airway stabilization with silicone stents for treating adult tracheobronchomalacia : A prospective observational study. / Ernst, Armin; Majid, Adnan; Feller-Kopman, David; Guerrero, Jorge; Boiselle, Phillip; Loring, Stephen H.; O'Donnell, Carl; DeCamp, Malcolm; Herth, Felix J F; Gangadharan, Sidhu; Ashiku, Simon.

In: Chest, Vol. 132, No. 2, 01.01.2007, p. 609-616.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Airway stabilization with silicone stents for treating adult tracheobronchomalacia

T2 - A prospective observational study

AU - Ernst, Armin

AU - Majid, Adnan

AU - Feller-Kopman, David

AU - Guerrero, Jorge

AU - Boiselle, Phillip

AU - Loring, Stephen H.

AU - O'Donnell, Carl

AU - DeCamp, Malcolm

AU - Herth, Felix J F

AU - Gangadharan, Sidhu

AU - Ashiku, Simon

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Rationale: It is postulated that in patients with severe tracheobronchomalacia (TBM), airway stabilization with stents may relieve symptoms. Objectives: To evaluate the effect of silicone stents (tracheal, mainstem bronchus, or both) on symptoms, quality of life, lung function, and exercise capacity in these patients. Methods: A prospective observational study in which baseline measurements were compared to those obtained 10 to 14 days after stent placement. Measurements and main results: Of 75 referred patients, 58 had severe disease and underwent therapeutic rigid bronchoscopy with stent placement. Mean age was 69 years (range, 39 to 91 years), 34 were men, 33 had COPD, and 13 had asthma. Almost all patients (n = 57) had dyspnea as a sole symptom or in combination with cough and recurrent infections; four patients required mechanical ventilation for respiratory failure. In 45 of 58 patients, there was reported symptomatic improvement; quality of life scores improved in 19 of 27 patients (p = 0.002); dyspnea scores improved in 22 of 24 patients (p = 0.001); functional status scores improved in 18 of 26 patients (p = 0.002); and mean exercise capacity improved from baseline, although not significantly. The 49 complications included mainly 21 partial stent obstructions, 14 infections, and 10 stent migrations. Most patients with concomitant COPD also improved on most measures. Conclusions: In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status. Coexisting COPD is not an absolute contraindication to a stenting trial in this population. Stenting is associated with a high number of short-term and long-term but generally reversible complications.

AB - Rationale: It is postulated that in patients with severe tracheobronchomalacia (TBM), airway stabilization with stents may relieve symptoms. Objectives: To evaluate the effect of silicone stents (tracheal, mainstem bronchus, or both) on symptoms, quality of life, lung function, and exercise capacity in these patients. Methods: A prospective observational study in which baseline measurements were compared to those obtained 10 to 14 days after stent placement. Measurements and main results: Of 75 referred patients, 58 had severe disease and underwent therapeutic rigid bronchoscopy with stent placement. Mean age was 69 years (range, 39 to 91 years), 34 were men, 33 had COPD, and 13 had asthma. Almost all patients (n = 57) had dyspnea as a sole symptom or in combination with cough and recurrent infections; four patients required mechanical ventilation for respiratory failure. In 45 of 58 patients, there was reported symptomatic improvement; quality of life scores improved in 19 of 27 patients (p = 0.002); dyspnea scores improved in 22 of 24 patients (p = 0.001); functional status scores improved in 18 of 26 patients (p = 0.002); and mean exercise capacity improved from baseline, although not significantly. The 49 complications included mainly 21 partial stent obstructions, 14 infections, and 10 stent migrations. Most patients with concomitant COPD also improved on most measures. Conclusions: In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status. Coexisting COPD is not an absolute contraindication to a stenting trial in this population. Stenting is associated with a high number of short-term and long-term but generally reversible complications.

KW - Airway stabilization

KW - Bronchoscopy

KW - COPD

KW - Stent placement

KW - Tracheobronchomalacia

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Ernst A, Majid A, Feller-Kopman D, Guerrero J, Boiselle P, Loring SH et al. Airway stabilization with silicone stents for treating adult tracheobronchomalacia: A prospective observational study. Chest. 2007 Jan 1;132(2):609-616. https://doi.org/10.1378/chest.06-2708