The following is a summary of “How risky is it to remove an airway stent?,” published in the June 2023 issue of Pulmonology by Salguero, et al.
Traditionally, removing airway stents has been associated with a high rate of complications. However, most studies on stent removal need to be updated and may reflect current practices, especially considering the advancements in anti-cancer therapies and the availability of contemporary stent types. For a study, researchers sought to report the outcomes of airway stent removal using more contemporary practices based on the experience at Mount Sinai Hospital.
A retrospective review was conducted on airway stent removal procedures performed between 2018 and 2022 in adult patients with benign or malignant airway diseases. Stent removals performed for stent trials for tracheobronchomalacia were excluded from the analysis.
A total of 43 airway stent removals in 25 patients were included in the study. Among these, 58% of the stents (25) were removed in 10 patients with benign diseases, while the remaining 42% (18) were removed in 15 patients with malignant diseases. Patients with benign diseases were likelier to undergo stent removal (odds ratio 3.88). Silicone stents accounted for 63% of the removed stents. Migration (31.1%) and treatment response (28.9%) were the most common reasons for stent removal. Rigid bronchoscopy was utilized in 86% of the cases, and 98% of the removal procedures were accomplished in a single procedure. The median time for stent removal was 32.5 days. Three complications were reported, including hemorrhage (n=1, 2.3%) and stridor (n = 2, 4.6%), with one difficulty not directly related to the stent removal.
With rigid bronchoscopy, covered metal or silicone airway stents can be safely removed in the era of contemporary stents, improved cancer-directed therapies, and surveillance bronchoscopies. It suggested that the current practices have resulted in favorable outcomes for airway stent removal procedures.