Airway Stenting in Benign and Malignant Diseases

Airway stenting is an important technique for the treatment of central airway obstruction and is a major component of an integrated Interventional Pulmonology service. Indications for this intervention can be broadly divided into malignant and benign conditions. Malignant airway obstruction is the commonest indication and can happen due to endobronchial tumors or external compression. Benign conditions include stenosis, fistula and airway malacia. An important consideration in benign conditions is patient longevity. Two groups of stents are available- silicon and metallic. Each is associated with advantages and disadvantages and the choice of stents depends on a number of factors including airway and disease related factors, physician choice and expertise and the available equipment within the endoscopy unit. Silicone stents require rigid bronchoscopy for placement while metallic stents can be deployed using flexible bronchoscopy. Irrespective of prosthesis type, stent related complications occur and include migration, stent obstruction from mucus, tumor ingrowth or granulation tissue and stent fracture. Finally, novel drug eluting and biodegradable stents are being studied with promising early results.

Keywords: airway, bronchoscopy, fistula, malacia, malignant, metallic, silicone, stents, stenosis.