Biodegradable airway stents: Novel treatment of airway obstruction in children

Background. Tracheobronchomalacia is the most common cause of congenital airway obstruction in infants. An alternative for surgical approach (aortopexy) can be metallic airway stents. Usually, they are not considered as a first choice because of the relatively high risk of complications. Recent years have brought encouraging reports of biodegradable stents applied in children. Objectives. The aim of this study was to report our experience in the treatment of airway malacia using biodegradable stents. Material and methods. Six polydioxanone (PDS), self-expanding custom-made stents (ELLA-CS) were implanted in 2 children: 3 in the patient with left main bronchus occlusion due to postpnemonectomy syndrome and 3 stents in the baby with tracheomalacia. Results. Airway collapse was always relieved after stent expansion. Both patients needed repeated stenting because of limited stent lifespan. All the stents were implanted without complications through a rigid bronchoscope. The baby with stented main bronchus died because of irreversible lung lesion. Conclusions. This small study shows that biodegradable airway stents seem to be an attractive option in the treatment of tracheobronchomalacia in children. We consider this method to be safe, effective, repeatable, and reversible in small children with growing airways. As a time-buying procedure they can be especially useful in the treatment of tracheobronchomalacia.