Implantation of a Hydrophilic Polymer Coated Silicone
Airway Stent Improves Airway Injury and Mucostasis
in a Porcine Model: A Pilot Study

Mahendra Pal*

Research Article

Implantation of a Hydrophilic Polymer Coated Silicone Airway Stent Improves Airway Injury and Mucostasis in a Porcine Model: A Pilot Study

Roy Joseph Cho¹*, Koji Kadowaki², Daniel E Glumac³, Leslie A Kent⁴, Ryan C Hunter⁴, Robroy H MacIver⁵, Gregory K Peterson⁶, Vidhu Pandey⁷, Davis Seelig⁸ and Kazuhiro Tanahashi²

¹Section of Interventional Pulmonary, Division of pulmonary, allergy, critical care and sleep medicine, USA

²Advanced Materials Research Laboratories, Toray Industries, Inc., Japan

³University of Minnesota Bakken Medical Devices Center, USA

⁴Department of Microbiology & Immunology, University of Minnesota, USA

⁵Children’s Heart Clinic, Children’s Hospitals and Clinics of Minnesota. University of Minnesota, USA

⁶Earl E Bakken Medical Devices Center, University of Minnesota, USA

⁷Department of Internal Medicine and Pediatrics, University of Minnesota, USA

⁸College of Veterinary Medicine, Department of Veterinary Clinical Sciences, University of Minnesota, USA

Corresponding Author

Received Date: June 18, 2022; Published Date: July 06, 2022

Abstract

Background: Mucous buildup is a significant cause for stent exchange, with mucous being implicated as the reason for up to 25% of stent exchanges [1-3]. Furthermore, impaired mucous clearance is thought to lead to infections, which can cause airway inflammation, growth of granulation tissue, and further airway stenosis. Prevention of mucous buildup in airway stents may be an improvement that could have a significant impact on patient quality of life as well as both material cost of stent replacement, and procedural time.

Purpose: Our group has developed a hydrophilic coating for silicone stents which reduces mucous adhesion compared to non-coated stents in an in vitro model [4]. This reduction in mucous adhesion could be an opportunity to improve complications of stent placement. The aim of this pilot study is to investigate the degree of airway injury and mucostasis using silicone stents with and without this coating in a porcine model.

Methodology: We modified commercially available silicone stents with a hydrophilic polymer from Toray Industries. We used X-ray Photoelectron Spectroscopy (XPS) and Time-of-Flight Secondary Ion Mass Spectroscopy (TOF-SIMS) to analyze and confirm the hydrophilic polymer coating on the surface of the experimental stent. We conducted an in vivo survival study in a porcine model to compare the degree of airway injury and mucostasis between coated (Stent-X) vs non-coated (Stent-C) stented airways.

Results: We successfully implanted two 14x10mm silicone stents within the left (Stent-C) and right (Stent-X) mainstem bronchus in this porcine model. The animal survived to termination at 4-weeks. Both stents were intact without migration. Stent-X demonstrated reduced mucostasis (75mg vs 250mg), lower airway injury score (28 vs 44) and lower goblet cell hyperplasia on H&E staining compared to Stent-C.

Conclusion: Stent-X demonstrates promising anti-mucous adhesion capabilities resulting in less airway injury in this pilot study. Future work involving multiple randomized animal models will be needed to corroborate our findings.

Keywords: Interventional pulmonary, airway stent, bronchial stenosis, mucostasis, X-ray Photoelectron Spectroscopy (XPS), Time-of-Flight Secondary Ion Mass Spectroscopy (TOF-SIMS)

Article Details

Citation

Roy Joseph Cho, Koji Kadowaki, Daniel E Glumac, Leslie A Kent, Ryan C Hunter, et al., Implantation of a Hydrophilic Polymer Coated Silicone Airway Stent Improves Airway Injury and Mucostasis in a Porcine Model: A Pilot Study. Archives in Respiratory & Pulmonary Medicine. 1(1): 2022. ARPM.MS.ID.000504.