J Korean Soc Radiol.  2010 Aug;63(2):107-113.

Endobronchial Occlusion Stent: A Preliminary Experimental Study

• Choi YW
• Jeong WK
• Lee SH
• Heo JN
• Jeon SC
• Ko GY
• Song HY

Abstract

PURPOSE
To evaluate the safety and the technical feasibility of the use of an endobronchial occlusion stent and to get preliminary data for the development of the optimal material required for endobronchial occlusions.
MATERIALS AND METHODS
A commercialized, self-expandable tracheobronchial stent was modified; one half had a polyurethane cover with an occluded end and the other half was uncovered with a flaring configuration. The occluded end was placed such that it would face the distal lung. Under fluoroscopic guidance, seven stents were placed at the lower lobar bronchus in 6 mini-pigs. The bronchial obstruction was examined immediately after stent placement. Chest radiographs were taken at days 1, 7, 14, and 28 after stent placement and the removed airways from two, two, one, and one mini-pigs sacrificed on corresponding days were examined for the maintenance of bronchial obstruction.
RESULTS
Stents were successfully placed and induced the immediate bronchial obstruction in all mini-pigs. Five of seven airways with occlusion stents maintained an obstruction until the mini-pigs were sacrificed. Proximal stent migration occurred in two mini-pigs (29%), and pulmonary consolidations were observed distal to four of the stents (57%).
CONCLUSION
The placement of an endobronchial occlusion stent and the obstruction of targeted bronchi seem to be feasible, but an add-on check valve should be considered to prevent stent migration and obstructive pneumonia.

MeSH Terms

Bronchi
Bronchial Fistula
Lung
Pneumonia
Polyurethanes
Respiratory Tract Fistula
Stents
Thorax
Polyurethanes

Figure

• 

  Fig. 1 A half-covered endobronchial occlusion stent. The stent shows a polyurethane-covered half connected with an occluded end and uncovered the other half with flaring configuration. The stent is placed in the bronchus with the open end facing the proximal bronchus and the occluded end facing the distal lung.

• 

  Fig. 2 Follow-up chest radiographs and macroscopic features of a mini-pig after insertion of an endobronchial occlusion stent (pig No. 6). A. Chest radiograph obtained immediately after insertion shows a stent (arrow heads) in the right lower lobar bronchus. B. Spot radiograph taken immediately after A and during instillation of contrast material through an introducer catheter shows an occluded stent end (arrow head), confirming obstruction of the bronchus, and overflow of the contrast material into the contralateral lung (asterisk). C. Chest radiograph taken on day 1 does not show stent (arrow head) migration or distal pulmonary consolidation. D. Chest radiograph taken on day 7 shows some extraluminal projection of the stent wire (arrow head) and distal pulmonary consolidation (asterisk). E. Chest radiograph on day 14 shows about 1 cm proximal migration of the stent (arrow head) and persistent distal pulmonary consolidation (asterisk). Extraluminal projection of some stent wires is noted again. F, G. Macroscopic features of the trachea and bronchus in the mini-pig that were killed on day 28. Gross specimen shows the stent in the right bronchus (F) and that exposed stent wires are partly covered by the bronchial epithelium (arrow head in G).

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