To Compare the Effects of a Standard Versus Hydrophilic Polymer Coated Airway Stent in a Porcine Model: A Randomized, Single-Blinded Study

Roy Joseph Cho, Koji Kadowaki, Davis Seelig, Daniel E. Glumac, Leslie A. Kent, Ryan C. Hunter, Robroy H. MacIver, Gregory K. Peterson, Vidhu Pandey, Kazuhiro Tanahashi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Stent encrustation with debris and mucostasis is a significant cause of airway injury and comorbidity, leading to 25% of stent exchanges (1-3). Previous work from our group has shown that the experimental coating can reduce mucous adhesion in bench testing and demonstrated a signal for reducing airway injury and mucostasis in a feasibility study. Objectives: The aim of this study is to continue our inquiry in a randomized, single-blinded multi-animal trial to investigate the degree of airway injury and mucostasis using silicone stents with and without this specialized coating. Methods: We modified commercially available silicone stents with a hydrophilic polymer from Toray Industries. We conducted an in vivo survival study in 6 mainstem airways (3 coated and 3 uncoated) of 3 pigs to compare the degree of airway injury and mucostasis between coated versus noncoated stented airways. Both stents were randomized to either left or right mainstem bronchus. The pathologist was blinded to the stent type. Results: We implanted a total of six 14×15 mm silicone stents (1 per mainstem bronchi) into 3 pigs. All animals survived to termination at 4 weeks. All stents were intact; however, 1 uncoated stent migrated out. On average, all the coated stents demonstrated reduced pathology and tissue injury scores (75 vs. 68.3, respectively). The average total dried mucous weight was slightly higher in the coated stents (0.07 g vs. 0.05 g; respectively). Conclusion: Coated stents had lower airway injury compared with uncoated stents in this study. Of all the stents, 1 uncoated stent migrated out and was not included in the dried mucous weight totals. This could explain the slightly higher mucous weight in the coated stents. Nevertheless, this current study demonstrates promising results in lowering airway injury in stents incorporated with the hydrophilic coating, and future studies, including a larger number of subjects, would be needed to corroborate our findings.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalJournal of Bronchology and Interventional Pulmonology
Volume31
Issue number2
DOIs
StatePublished - Apr 19 2024

Bibliographical note

Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • Interventional pulmonary
  • Time-of-Flight Secondary Ion Mass Spectroscopy (TOF-SIMS)
  • airway stent
  • bronchial stenosis
  • mucostasis
  • x-ray Photoelectron Spectroscopy (XPS)

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial, Veterinary

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