最近的材料科学进步正在推动气管支架的创新。我们试图评估成人良性气管疾病患者气管支架的材料和临床前/临床结果的科学状况。
2021年4月的全面文献检索确定了556篇与气管支架相关的文章。审查了128篇全文文章,最终分析了58篇。检查的数据点是支架材料,临床应用和结果,和临床前发现,包括新兴技术。
在纳入的58项研究中,支架材料为金属(n=28),聚合物(n=19),涂层支架(n=19),和药物洗脱(n=5)。金属包括镍钛诺,钢,镁合金,还有Elgiloy.研究使用了10种不同的聚合物,最受欢迎的包括聚二恶烷酮,聚-l-乳酸,聚(d,l-丙交酯-共-乙交酯),和聚己内酯。涂层支架采用金属或聚合物框架,并涂有聚氨酯,硅胶,聚四氟乙烯,或聚酯,与一些聚合物涂层专门设计用于药物洗脱。药物洗脱支架使用丝裂霉素C,三氧化二砷,紫杉醇,雷帕霉素,和强力霉素.在58项研究中,18个是人,40个是动物研究(草胺=21,犬=9,猪=4,大鼠=3,绵羊/猫/鼠=1)。值得注意的并发症包括肉芽组织和/或狭窄,支架迁移,死亡,感染,和碎片化。
气管支架使用的材料和涂层的多样性越来越多,在过去的十年里越来越明显。尽管大多数研究仍处于临床前阶段,气管支架发展的认识是重要的背景下,新的支架的概念和临床试验。喉镜,132:2111-2123,2022年。
Recent material science advancements are driving tracheal stent innovation. We sought to assess the state of the science regarding materials and preclinical/clinical outcomes for tracheal stents in adults with benign tracheal disease.
A comprehensive literature search in April 2021 identified 556 articles related to tracheal stents. One-hundred and twenty-eight full-text articles were reviewed and 58 were included in the final analysis. Datapoints examined were stent materials, clinical applications and outcomes, and preclinical findings, including emerging technologies.
In the 58 included studies, stent materials were metals (n = 28), polymers (n = 19), coated stents (n = 19), and drug-eluting (n = 5). Metals included nitinol, steel, magnesium alloys, and elgiloy. Studies utilized 10 different polymers, the most popular included polydioxanone, poly-l-lactic acid, poly(d,l-lactide-co-glycolide), and polycaprolactone. Coated stents employed a metal or polymer framework and were coated with polyurethane, silicone, polytetrafluoroethylene, or polyester, with some polymer coatings designed specifically for drug elution. Drug-eluting stents utilized mitomycin C, arsenic trioxide, paclitaxel, rapamycin, and doxycycline. Of the 58 studies, 18 were human and 40 were animal studies (leporine = 21, canine = 9, swine = 4, rat = 3, ovine/feline/murine = 1). Noted complications included granulation tissue and/or stenosis, stent migration, death, infection, and fragmentation.
An increasing diversity of materials and coatings are employed for tracheal stents, growing more pronounced over the past decade. Though most studies are still preclinical, awareness of tracheal stent developments is important in contextualizing novel stent concepts and clinical trials. Laryngoscope, 132:2111-2123, 2022.