Research Progress of Biodegradable Trachea Stent_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIUFa-bing , RUANZheng

Department of Thoracic Surgery, The First People's Hospital, Affiliated to Shanghai Jiaotong University, Shanghai 200080, P. R. China;

Corresponding author：

LIUFa-bing, Email: fabingliu@hotmail.com

Keywords：

Biodegradation; Trachea; Stent; Transplantation

DOI：

10.7507/1007-4848.20160067

Video：

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Abstract Full text Figures/Tables Video References Cited by

Tracheal stents are often used to maintain the patency of the trachea and bronchia in patients suffering from central airway lesions. Metallic tracheal stents are now widely used in the clinical setting, but these types of stents can cause many intractable material-related complications. Biodegradable tracheal stents are made of biodegradable polymer materials with good mechanical strength for maintaining the patency of the lesion segment during a certain period of time, and then they can be gradually degraded into harmless products in human body. Compared with conventional metallic tracheal stent, biodegradable tracheal stents have a good prospect in clinic. In this article, we review the choice of biodegradable tracheal stent materials, experimental progress in biodegradable tracheal stent as well as the challenges we are facing.

Citation： LIUFa-bing, RUANZheng. Research Progress of Biodegradable Trachea Stent. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(3): 289-293. doi: 10.7507/1007-4848.20160067 Copy

1.	Al-Ayoubi AM, Bhora FY. Current readings: the role of stenting in tracheobronchial disease. Semin Thorac Cardiovasc Surg, 2014, 26(1): 71-75.
2.	Stoelben E, Koryllos A, Beckers F, et al. Benign stenosis of the trachea. Thorac Surg Clin, 2014, 24(1): 59-65.
3.	Ernst A, Feller-Kopman D, Becker HD, et al. Central airway obstruc-tion. Am J Respir Crit Care Med, 2004, 169(12): 1278-1297.
4.	Lee P, Kupeli E, Mehta AC. Airway stents. Clin Chest Med, 2010, 31(1): 141-150.
5.	Chin CS, Litle V, Yun J,et al. Airway stents. Ann Thorac Surg,2008, 85(2): S792-S796.
6.	Breitenbücher A, Chhajed PN, Brutsche MH, et al. Long-term follow-up and survival after Ultraflex stent insertion in the manage-ment of complex malignant airway stenoses. Respiration, 2008, 75(4): 443-449.
7.	Lim LH, Cotton RT, Azizkhan RG, et al. Complications of metallic stents in the pediatric airway. Otolaryngol Head Neck Surg, 2004, 131(4): 355-361.
8.	Alexy RD, Levi DS. Materials and manufacturing technologies available for production of a pediatric bioabsorbable stent. Biomed Res Int, 2013, (2013): 137985.
9.	Lochbihler H, Hoelzl J, Dietz HG. Tissue compatibility and biode-gradation of new absorbable stents for tracheal stabilization: an experimental study. J Pediatr Surg, 1997, 32(5): 717-720.
10.	Nikam N, Steinberg TB, Steinberg DH. Advances in stent techno-logies and their effect on clinical efficacy and safety. Med Devices (Auckl), 2014, 7: 165-178.
11.	Zilberman M, Nelson KD, Eberhart RC. Mechanical properties and in vitro degradation of bioresorbable fibers and expandable fiber-based stents. J Biomed Mater Res B Appl Biomater, 2005, 74(2): 792-799.
12.	Shin JH, Sung KB, Kim EY, et al. A rat tracheal model to investigate stent-induced tissue hyperplasia: a pilot study. J Vasc Interv Radiol, 2010, 21(12): 1878-1883.
13.	Korpela A, Aarnio P, Sariola H, et al. Comparison of tissue reactions in the tracheal mucosa surrounding a bioabsorbable and silicone airway stents. Ann Thorac Surg, 1998, 66(5): 1772-1776.
14.	Laçin NT, Utkan GG. Role of biomaterials in prevention of in-stent restenosis. J Biomed Mater Res B Appl Biomater, 2014, 102(5): 1113-1120.
15.	Basha J, Appasani S, Vaiphei K, et al. Biodegradable stents: truly biodegradable with good tissue harmony. Endoscopy, 2013, 45(Suppl 2):E116-E117.
16.	Bosje JT, Den Hertog E. Stenting: a new option for tracheal collapse. Tijdschr Diergeneeskd, 2009, 134(3): 112-113.
17.	He D, Liu W, Zhang T. The development of carotid stent material. Interv Neurol, 2015, 3(2): 67-77.
18.	Ng AH, Ng NS, Zhu GH, et al. A fully degradable tracheal stent: in vitro and in vivo characterization of material degradation. J Biomed Mater Res B Appl Biomater, 2012, 100(3): 693-699.
19.	Juuti H, Kotsar A, Mikkonen J, et al. The effect of pH on the degradation of biodegradable poly(L-lactide-co-glycolide) 80/20 urethral stent material in vitro. J Endourol, 2012, 26(6): 701-705.
20.	Wiebe J, Nef HM, Hamm CW. Current status of bioresorbable scaffolds in the treatment of coronary artery disease. J Am Coll Cardiol, 2014, 64(23): 2541-2551.
21.	Sammel AM, Chen D, Jepson N. New generation coronary stent technology is the future biodegradable? Heart Lung Circ, 2013, 22(7): 495-506.
22.	Ham YH, Kim GH. Plastic and biodegradable stents for complex and refractory benign esophageal strictures. Clin Endosc, 2014, 47(4): 295-300.
23.	Van Boeckel PG, Vleggaar FP, Siersema PD. Biodegradable stent placement in the esophagus. Expert Rev Med Devices, 2013, 10(1): 37-43.
24.	Repici A, Pagano N, Rando G, et al. A retrospective analysis of early and late outcome of biodegradable stent placement in the management of refractory anastomotic colorectal strictures. Surg Endosc, 2013, 27(7): 2487-2491.
25.	Rejchrt S, Kopacova M, Brozik J, et al. Biodegradable stents for the treatment of benign stenoses of the small and large intestines. Endoscopy, 2011, 43(10): 911-917.
26.	Petrtýl J, Brůha R, Horák L, et al. Management of benign intrahe-patic bile duct strictures: initial experience with polydioxanone biodegradable stents. Endoscopy, 2010, 42(Suppl. 2): E89-E90.
27.	Sabino MA, Gonzalez S, Marquez L, et al. Study of the hydrolytic degradation of polydioxanone PPDX. Pol Degradat & Stabil, 2000, 69(2): 209-216.
28.	Ruan Z, Wang YW, Wang SH, et al. Primary results of chest wall reconstruction with polydioxanone mesh on animals. Eur Rev Med Pharmacol Sci, 2012, 16(7): 942-948.
29.	Repici A, Vleggaar FP, Hassan C, et al. Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study. Gastrointest Endosc, 2010, 72(5): 927-934.
30.	Novotny L, Crha M, Rauser P, et al. Novel biodegradable polydioxa-none stents in a rabbit airway model. J Thorac Cardiovasc Surg, 2012, 143(2): 437-444.
31.	Vondrys D, Elliott MJ, McLaren CA, et al. First experience with biodegradable airway stents in children. Ann Thorac Surg, 2011, 92(5): 1870-1874.
32.	Lischke R, Pozniak J, Vondrys D, et al. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg, 2011, 40(3): 619-624.
33.	Freed LE, Vunjak-Novakovic G, Biron RJ, et al. Biodegradable polymer scaffoids for tissue engineering.Biotechnology(NY), 1994, 12(7):689-693.
34.	Korpela A, Aarnio P, Sariola H, et al. Bioabsorbable self-reinforced poly-L-lactide, metallic, and silicone stents in the management of experimental tracheal stenosis. Chest, 1999, 115(2): 490-495.
35.	Saito Y, Minami K, Kobayashi M, et al. New tubular bioabsorbable knitted airway stent: biocompatibility and mechanical strength. J Thorac Cardiovasc Surg, 2002, 123(1): 161-167.
36.	Sun H, Mei L, Song C, et al. The in vivo degradation, absorption and excretion of PCL-based implant. Biomaterials,2006, 27(9): 1735-1740.
37.	Liu KS, Liu YH, Peng YJ, et al. Experimental absorbable stent permits airway remodeling. J Thorac Cardiovasc Surg, 2011, 141(2): 463-468.
38.	Bettinger CJ, Bruggeman JP, Borenstein JT, et al. Amino alcohol-based degradable poly(ester amide) elastomers. Biomaterials, 2008, 29(15): 2315-2325.
39.	Wang J, Boutin KG, Abdulhadi O, et al. Fully Biodegradable Airway Stents Using Amino Alcohol-Based Poly(ester amide) Elastomers. Adv Healthc Mater, 2013, 2(10): 1329-1936.
40.	Chao YK1, Liu KS, Wang YC, et al. Biodegradable cisplatin-eluting tracheal stent for malignant airway obstruction: in vivo and in vitro studies. Chest, 2013, 144(1): 193-199.
41.	Heo DN, Lee JB, Bae MS, et al. Development of nanofiber coated indomethacin-eluting stent for tracheal regeneration. J Nanosci Nanotechnol, 2011, 11(7): 5711-5716.
42.	Yamamoto Y, Okamoto T, Goto M, et al. Experimental study of bone morphogenetic proteins-2 slow release from an artificial trachea made of biodegradable materials: evaluation of stenting time. ASAIO J, 2003, 49(5): 533-536.
43.	Zheng SX, Zhao WH, Lu BH. 3D reconstruction of the structure of a residual limb for customising the design of a prosthetic socket. Med Eng Phys, 2005, 27(1): 67-74.
44.	Seydler B, Schmitter M. Esthetic restoration of maxillary incisors using CAD/CAM chairside technology--a case report.Quintessence Int, 2011, 42(7): 533-537.
45.	Hytych V, Horazdovsky P, Stehlik L, et al. Our own method of fixation of biodegradable tracheal stent. Bratisl Lek Listy, 2015, 116(5): 340-342.

1. Al-Ayoubi AM, Bhora FY. Current readings: the role of stenting in tracheobronchial disease. Semin Thorac Cardiovasc Surg, 2014, 26(1): 71-75.
2. Stoelben E, Koryllos A, Beckers F, et al. Benign stenosis of the trachea. Thorac Surg Clin, 2014, 24(1): 59-65.
3. Ernst A, Feller-Kopman D, Becker HD, et al. Central airway obstruc-tion. Am J Respir Crit Care Med, 2004, 169(12): 1278-1297.
4. Lee P, Kupeli E, Mehta AC. Airway stents. Clin Chest Med, 2010, 31(1): 141-150.
5. Chin CS, Litle V, Yun J,et al. Airway stents. Ann Thorac Surg,2008, 85(2): S792-S796.
6. Breitenbücher A, Chhajed PN, Brutsche MH, et al. Long-term follow-up and survival after Ultraflex stent insertion in the manage-ment of complex malignant airway stenoses. Respiration, 2008, 75(4): 443-449.
7. Lim LH, Cotton RT, Azizkhan RG, et al. Complications of metallic stents in the pediatric airway. Otolaryngol Head Neck Surg, 2004, 131(4): 355-361.
8. Alexy RD, Levi DS. Materials and manufacturing technologies available for production of a pediatric bioabsorbable stent. Biomed Res Int, 2013, (2013): 137985.
9. Lochbihler H, Hoelzl J, Dietz HG. Tissue compatibility and biode-gradation of new absorbable stents for tracheal stabilization: an experimental study. J Pediatr Surg, 1997, 32(5): 717-720.
10. Nikam N, Steinberg TB, Steinberg DH. Advances in stent techno-logies and their effect on clinical efficacy and safety. Med Devices (Auckl), 2014, 7: 165-178.
11. Zilberman M, Nelson KD, Eberhart RC. Mechanical properties and in vitro degradation of bioresorbable fibers and expandable fiber-based stents. J Biomed Mater Res B Appl Biomater, 2005, 74(2): 792-799.
12. Shin JH, Sung KB, Kim EY, et al. A rat tracheal model to investigate stent-induced tissue hyperplasia: a pilot study. J Vasc Interv Radiol, 2010, 21(12): 1878-1883.
13. Korpela A, Aarnio P, Sariola H, et al. Comparison of tissue reactions in the tracheal mucosa surrounding a bioabsorbable and silicone airway stents. Ann Thorac Surg, 1998, 66(5): 1772-1776.
14. Laçin NT, Utkan GG. Role of biomaterials in prevention of in-stent restenosis. J Biomed Mater Res B Appl Biomater, 2014, 102(5): 1113-1120.
15. Basha J, Appasani S, Vaiphei K, et al. Biodegradable stents: truly biodegradable with good tissue harmony. Endoscopy, 2013, 45(Suppl 2):E116-E117.
16. Bosje JT, Den Hertog E. Stenting: a new option for tracheal collapse. Tijdschr Diergeneeskd, 2009, 134(3): 112-113.
17. He D, Liu W, Zhang T. The development of carotid stent material. Interv Neurol, 2015, 3(2): 67-77.
18. Ng AH, Ng NS, Zhu GH, et al. A fully degradable tracheal stent: in vitro and in vivo characterization of material degradation. J Biomed Mater Res B Appl Biomater, 2012, 100(3): 693-699.
19. Juuti H, Kotsar A, Mikkonen J, et al. The effect of pH on the degradation of biodegradable poly(L-lactide-co-glycolide) 80/20 urethral stent material in vitro. J Endourol, 2012, 26(6): 701-705.
20. Wiebe J, Nef HM, Hamm CW. Current status of bioresorbable scaffolds in the treatment of coronary artery disease. J Am Coll Cardiol, 2014, 64(23): 2541-2551.
21. Sammel AM, Chen D, Jepson N. New generation coronary stent technology is the future biodegradable? Heart Lung Circ, 2013, 22(7): 495-506.
22. Ham YH, Kim GH. Plastic and biodegradable stents for complex and refractory benign esophageal strictures. Clin Endosc, 2014, 47(4): 295-300.
23. Van Boeckel PG, Vleggaar FP, Siersema PD. Biodegradable stent placement in the esophagus. Expert Rev Med Devices, 2013, 10(1): 37-43.
24. Repici A, Pagano N, Rando G, et al. A retrospective analysis of early and late outcome of biodegradable stent placement in the management of refractory anastomotic colorectal strictures. Surg Endosc, 2013, 27(7): 2487-2491.
25. Rejchrt S, Kopacova M, Brozik J, et al. Biodegradable stents for the treatment of benign stenoses of the small and large intestines. Endoscopy, 2011, 43(10): 911-917.
26. Petrtýl J, Brůha R, Horák L, et al. Management of benign intrahe-patic bile duct strictures: initial experience with polydioxanone biodegradable stents. Endoscopy, 2010, 42(Suppl. 2): E89-E90.
27. Sabino MA, Gonzalez S, Marquez L, et al. Study of the hydrolytic degradation of polydioxanone PPDX. Pol Degradat & Stabil, 2000, 69(2): 209-216.
28. Ruan Z, Wang YW, Wang SH, et al. Primary results of chest wall reconstruction with polydioxanone mesh on animals. Eur Rev Med Pharmacol Sci, 2012, 16(7): 942-948.
29. Repici A, Vleggaar FP, Hassan C, et al. Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study. Gastrointest Endosc, 2010, 72(5): 927-934.
30. Novotny L, Crha M, Rauser P, et al. Novel biodegradable polydioxa-none stents in a rabbit airway model. J Thorac Cardiovasc Surg, 2012, 143(2): 437-444.
31. Vondrys D, Elliott MJ, McLaren CA, et al. First experience with biodegradable airway stents in children. Ann Thorac Surg, 2011, 92(5): 1870-1874.
32. Lischke R, Pozniak J, Vondrys D, et al. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg, 2011, 40(3): 619-624.
33. Freed LE, Vunjak-Novakovic G, Biron RJ, et al. Biodegradable polymer scaffoids for tissue engineering.Biotechnology(NY), 1994, 12(7):689-693.
34. Korpela A, Aarnio P, Sariola H, et al. Bioabsorbable self-reinforced poly-L-lactide, metallic, and silicone stents in the management of experimental tracheal stenosis. Chest, 1999, 115(2): 490-495.
35. Saito Y, Minami K, Kobayashi M, et al. New tubular bioabsorbable knitted airway stent: biocompatibility and mechanical strength. J Thorac Cardiovasc Surg, 2002, 123(1): 161-167.
36. Sun H, Mei L, Song C, et al. The in vivo degradation, absorption and excretion of PCL-based implant. Biomaterials,2006, 27(9): 1735-1740.
37. Liu KS, Liu YH, Peng YJ, et al. Experimental absorbable stent permits airway remodeling. J Thorac Cardiovasc Surg, 2011, 141(2): 463-468.
38. Bettinger CJ, Bruggeman JP, Borenstein JT, et al. Amino alcohol-based degradable poly(ester amide) elastomers. Biomaterials, 2008, 29(15): 2315-2325.
39. Wang J, Boutin KG, Abdulhadi O, et al. Fully Biodegradable Airway Stents Using Amino Alcohol-Based Poly(ester amide) Elastomers. Adv Healthc Mater, 2013, 2(10): 1329-1936.
40. Chao YK1, Liu KS, Wang YC, et al. Biodegradable cisplatin-eluting tracheal stent for malignant airway obstruction: in vivo and in vitro studies. Chest, 2013, 144(1): 193-199.
41. Heo DN, Lee JB, Bae MS, et al. Development of nanofiber coated indomethacin-eluting stent for tracheal regeneration. J Nanosci Nanotechnol, 2011, 11(7): 5711-5716.
42. Yamamoto Y, Okamoto T, Goto M, et al. Experimental study of bone morphogenetic proteins-2 slow release from an artificial trachea made of biodegradable materials: evaluation of stenting time. ASAIO J, 2003, 49(5): 533-536.
43. Zheng SX, Zhao WH, Lu BH. 3D reconstruction of the structure of a residual limb for customising the design of a prosthetic socket. Med Eng Phys, 2005, 27(1): 67-74.
44. Seydler B, Schmitter M. Esthetic restoration of maxillary incisors using CAD/CAM chairside technology--a case report.Quintessence Int, 2011, 42(7): 533-537.
45. Hytych V, Horazdovsky P, Stehlik L, et al. Our own method of fixation of biodegradable tracheal stent. Bratisl Lek Listy, 2015, 116(5): 340-342.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research Progress of Biodegradable Trachea Stent

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