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. 2022 Jan 20;11(3):517.
doi: 10.3390/jcm11030517.

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Xiaojian Qiu  1 , Yan Liu  1 , Jie Zhang  1 , Ting Wang  1 , Juan Wang  1
Affiliations

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis

Xiaojian Qiu et al. J Clin Med. .

Abstract

Background: Airway stent implantation used in the treatment of benign cicatricial airway stenosis (BCAS) can lead to local granulation and scar formation, resulting in restenosis and treatment failure.

Methods: We systematically investigated a paclitaxel-loaded PLGA-coating stent (PLPCS) and analyzed the safety and efficacy of the PLPCS in patients with BCAS. Patients were enrolled from four hospitals in China and observed for six months after implantation, by bronchoscopy performed weekly in the first month and monthly thereafter. The stent was removed immediately upon detection of granulation tissue proliferation, leading to immobility of the stent.

Results: Granulation tissue was formed one week after stent implantation, most of which was located at the upper edge of the stent and the narrowest airway in the stent. All stents were removed in three months (mean: 6.51 + 4.67 weeks), with a curative outcome in one case and ineffective results in two. The remaining seven patients developed complications within three months, necessitating early stent removal. The main complication was granulation formation, resulting in difficulty in stent removal.

Conclusion: Although PLPCS showed beneficial effects in basic and animal experiments, it cannot prevent airway restenosis in actual practice, mainly due to granulation formation.

Keywords: benign airway stenosis; paclitaxel; stent; treatment.

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Conflict of interest statement

The authors declare no conflict of interest. The sponsors had no role in the design, execution, interpretation, or writing of the study.

Figures

Figure 1
Figure 1
(a) Before treatment: tracheal stenosis after tuberculosis. (b) After treatment: implant PLPCS. (c) One week after stent implant: a small amount of granulation hyperplasia at the narrowest part of the airway. (d) Two months after stent implant: granulation hyperplasia was slightly aggravated than before. (e) Three months after stent implant: granulation proliferation showed no significant change compared with before. (f) After stent was removed: tracheal mucosa was granular and lumen was smooth. (g) One month after stent was removed: tracheal mucosa was granular and lumen was smooth. (h) Two months after stent was removed: tracheal mucosa was smooth and lumen was smooth. (i) Three months after stent was removed: tracheal mucosa was smooth and lumen was smooth.
Figure 2
Figure 2
(a) Three days after stent implant: granulation hyperplasia at the narrowest part of the airway. (b) One month after stent implant: granulation hyperplasia at the upper edge of the stent. (c) One month after stent implant: granulation hyperplasia at the narrowest part of the airway. (d) Five weeks after stent implant: removed the stent and placed a silicone stent.
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