Biodegradable polydioxanone stent in the treatment of post-intubation and post-tracheotomy stenosis.

Background: Biodegradable (BD) stents have already been used in various types of tracheal narrowing. We publish achievements in adult patients with complex post-intubation or post-tracheotomy stenoses. Objectives: To describe results we recorded with polydioxanone tracheal stents, to assess safety and efficacy of this approach. Methods: Indications included significant complex post-intubation or post-tracheotomy narrowing in cases where a primary surgical treatment was not possible. We used polydioxanone stents (ELLA-CS Ltd., Hradec Kralove, Czech Republic) which were implanted during rigid bronchoscopy. This study received Institutional Ethics Committee approval, was supported by grant Nr. G1302 (NT 14146-3/2013) and Czech Ministry of Health Institutional support no. RVO-TN/2016. Results: Between July 2013 and December 2016, we implanted 22 stents in 14 patients. Short-term effect was evident in all cases, 7 patients experienced significant long-term benefit through tracheal remodeling. The longer time needed to renew tracheal patency was 10 months, 3 stents were implanted consecutively.3 patients died of comorbidities before complete stent degradation, one patient underwent tracheal resection due to residual narrowing after he improved and became a candidate for surgery, in another one, recurrent stenosis after 2nd BD stent necessitated a silicone stent, two patients have already not degraded their stents. Early failure was not observed. Repeated bronchoscopies and re-stentings were necessary. Conclusion: BD stents seem to be a safe alternative to traditional types of stents in well-selected patients with post-tracheotomy and post-intubation stenoses.