Where do the Airway Stents are Indicated?
Central airway obstruction refers to blockage of the trachea and main stem bronchi by Malignant causes are most often lung cancer though other malignancies metastatic to the lung can also lead to airway obstruction. Non-malignant causes include post-intubation or post-tracheostomy stenosis or those related to post-lung transplant healing, post TB and autoimmune disease.
Weakness of the airway wall such as in tracheobronchomalacia in which the airway wall collapses to variable degrees.
Defects in the airway wall such as airway fistulae (due to cancer or trauma, for example Tracheo esophageal Fistula). Anastomotic dehiscence after lung resection or transplantation may also require a stent to bridge these gaps.
Symptoms of Lung Obstructions
Shortness of breath is the definitive symptom of a lung obstruction. The patient may initially only feel out of breath after light activity. They may also have symptoms like stridor, wheezing, a chronic cough, and repeated respiratory infections. The symptoms can vary from person to person and tend to get worse with time.
What are Airway Stents and how do they help you breathe better?
Airway Stents are put in place to hold lung obstructions and narrowed portions of the trachea or bronchi open. They are hollow, thin, flexible, but strong tubes, inserted into the blocked airway to help patients breathe. You could compare the stent to a PVC pipe, passing through a thick wall. The stent opens up a passage for the air inhaled to reach the alveoli. The patient regains the use of all their alveoli, allowing them to exchange oxygen and carbon dioxide more efficiently in the lungs. The stent also gives the damaged trachea or bronchi some structural integrity. The airway stents can be made of various materials – metal, silicone or hybrid. The doctor will decide the size and material of the stent after looking at the patient’s chest CT and assessing the extent of the blockages. The doctor will also assess how long the stent needs to stay in place, and remove it as required.
Types of Airway Stents
The design of airway stents has evolved through time, as more research is conducted in the field. Biomedical engineers have experimented with different materials and operational designs:
Silicone Stents – Silicone stents are inert, and easy for the body to tolerate. Silicone is also flexible, and easy to bend to suit the situation. Silicone stents are made in various designs including straight, Y-shaped and expandable. They are easy to place, reposition and remove.
Metallic Stents – Metallic Stents may be made of stainless steel or nickel-titanium alloys. Metal stents are usually self-expanding. Metal stents are also good because they resist migration within the lungs, staying put where they are placed. Consequently, they are a little difficult to reposition and remove.
Hybrid Stents – Hybrid stents are designed to combine the best features of metal stents and silicone stents. They are usually made of a metal cage or framework, coated with silicone or a polymer like PU or PTFE. The coating on the metal framework prevents ingrowth of tumour tissue inside the stent.
Placement of Airway Stents – Bronchoscopy
The placement of the airway stent is performed by an interventional pulmonologist. The stent can be placed using the bronchoscope, in a minimally invasive procedure. The patient is placed under an anaesthesia, through an IV line. A Rigid Bronchoscope is used as conduit of pathway based on indication along with the Flexible bronchoscope is a long, thin, flexible tube with a light and a camera on the end is used. It is inserted into the patient’s mouth or nose, into the lungs. It is then navigated into the trachea or bronchi, to the site of the obstruction and tissue damage. The camera provides visual data from within the trachea and bronchi, as the bronchoscope is inserted. X-ray fluoroscopy may also be used to help guide the scope. The doctor may choose to perform a biopsy during the stenting procedure, by removing a slice of the tumour through the bronchoscope for testing. Once the bronchoscope is in place, the stent (tube) is inserted through the scope, and pushed into place through direct vision or fluroscopy guided and stent is secured in position.
What to expect after the Airway Stent Placement Procedure
After the stent placement, the patient is moved to recovery. The patient’s heart rate, blood oxygen levels, breathing and blood pressure will be monitored while the anaesthesia wears off. Some patients cough up blood right after the procedure – This is considered a normal after-effect of the bronchoscope. This is temporary and the patient should stop coughing up blood shortly after they wake up. If the patient has also had a lung biopsy, the doctor may perform a follow-up chest X-ray after the surgery. Since this procedure involves no surgical incisions, the patient has no scarring. This helps them recover quickly. The doctor may prescribe oral and nebulised (vapourised, like an inhaler) medication to help keep the lungs clear of mucous.
Risks associated with Airway Stents
Airway stents do a good job at helping patients breathe, but they are not without risk. Although unlikely, the patient may sustain some bleeding and irritation of the vocal cords after stent placement. If the lung tissue is very damaged, the insertion of the bronchoscope can, in rare cases, puncture the lung, leading to a pneumothorax. Bronchial stents also come with a risk of migration – The stent can become dislodged, maybe during a particularly violent cough, and move to a different location in the lungs. This defeats the purpose of the stent. As we have discussed, airway stents are usually not permanent and are designed to be removed after some time. Sometimes, the airway collapses again, or becomes blocked by tissue overgrowth, after the stent is removed. If you are concerned about the potential complications of your stent placement procedure, feel free to discuss it with your pulmonologist. They will be able to advise you on your personal risk, based on your current condition.
If you’re experiencing breathing difficulties or want to know more about airway stent procedures, consult our team of expert pulmonologists at Kauvery Hospital. We have branches conveniently located in Chennai, Hosur, Salem, Tirunelveli, and Trichy, ensuring you receive advanced respiratory care close to home.
Frequently Asked Questions
What are airway stents and how do they work?
Airway stents are hollow, flexible tubes inserted into blocked or narrowed airways (trachea or bronchi) to keep them open. They improve airflow by holding the airway open, allowing better oxygen exchange in the lungs. Stents also offer structural support to weakened or damaged airways.
Who needs an airway stent?
Airway stents are used for patients with central airway obstruction due to lung cancer, tracheobronchomalacia, post-intubation stenosis, or airway fistulas. They are also used in non-cancerous conditions like post-tuberculosis airway narrowing or complications after lung transplants.
How is an airway stent placed during bronchoscopy?
An interventional pulmonologist places the airway stent using a bronchoscope under anesthesia. The bronchoscope, guided visually or with fluoroscopy, helps position the stent at the site of obstruction, restoring airflow without surgical incisions.
What types of airway stents are used in treatment?
The three main types of airway stents are:
- Silicone stents – easy to place and remove
- Metallic stents – self-expanding and secure
- Hybrid stents – combine flexibility and strength, with anti-tumor coatings
What should patients expect after airway stent placement?
After placement, patients may cough up blood temporarily. Vitals are monitored as anesthesia wears off. Most patients recover quickly and may be prescribed nebulized or oral medications to reduce mucus and prevent infection.
What are the possible risks of airway stents?
Airway stents may cause complications such as bleeding, voice changes, stent migration, or tissue regrowth blocking the airway. In rare cases, they can puncture the lung if the tissue is fragile. Most risks are minimal and manageable with expert care.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai Alwarpet – 044 4000 6000 • Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801