Effects of radiofrequency energy in metallic stent removal

Adnam Majid, William Lunn, Robert Garland, Yoshihiro Nakamura, Olivier Kocher, David Feller-Kopman, Heinrich D. Becker, Felix Herth, Malcolm Decamp, Armin Ernst*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Metallic stents are frequently used to treat airway obstruction. Complications such as obstruction or fracture of the stent wire are common and may require removal of the device. This is usually carried out by endoscopic approaches, which can be difficult and are associated with significant complications. The hypothesis is that pretreatment of the stent with thermal energy will destroy granulation tissue and facilitate removal. Methods: The study is a prospective, controlled investigation of the effects of radiofrequency energy (RFE) treatment before the removal of metallic stents in pigs. All animals underwent metallic uncovered tracheal stent placement. After 4 weeks of observation and epithelization of the stent, animals were scheduled for RFE treatment followed by immediate removal of the stent (N = 2) and removal at 96 hours after treatment (N = 2). Radiofrequency energy was applied at different levels of the stented trachea. After stent removal, all animals were killed and a pulmonary pathologist analyzed the tracheal specimens. The amount of blood loss was quantified and the degree of difficulty in removing the stents was judged clinically. The effects of RFE on the tracheal airways were assessed. Results: Animals (N = 2) pretreated with RFE with immediate removal of the stents had a significant amount of bleeding, airway trauma, severe airway obstruction, and >90% of the stent was retained. The degree of technical difficulty was graded as complicated. Animals (N = 2) pretreated with RFE with delayed removal of the stent (at 96 hours) had minimal bleeding, airway trauma, and the stents were removed >95% intact. RFE impact on the airway wall itself was limited and the cartilage integrity was preserved. Conclusions: The result of our investigation suggests that RFE is a promising technology that can be used safely in stented airway mucosa. Delayed removal after RFE treatment may significantly simplify metallic stent removal.

Original languageEnglish (US)
Pages (from-to)196-199
Number of pages4
JournalJournal of Bronchology
Volume12
Issue number4
DOIs
StatePublished - Oct 1 2005

Keywords

  • Metallic stents
  • Radiofrequency ablation (RFA)
  • Radiofrequency energy (RFE)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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