Silicone stent versus fully covered metallic stent in malignant central airway stenosis.

ABSTRACT Background Airway stenting to restore airway patency in cases of malignant central airway obstruction (CAO) is an effective palliation treatment. Our goal was to compare the efficacy after deployment and complications of a fully covered Self-Expandable Metal Stent -SEMS- (Aerstent) and a silicone stent (Dumon). Methods Retrospective cohort of two similar groups of patients with malignant CAO treated with stents between August 2012 and July 2017. Complications were assessed bronchoscopically. A competing risk of death analysis was performed to adjust probability of developing a complication. Results 70 patients (29 patients with Silicone stents and 41 with SEMS) were included. Stent insertion was successful in all cases. Mucus retention was the most frequent complication (75.9% with silicone stent and 84.8% with SEMS; p=0.51), followed by granulation tissue (51.7% with silicone stent and 41.3% with SEMS; p=0.52) and migration (6.9% with silicone stent and 13.0% with SEMS; p=0.47). In the first month, the cumulative incidence of a complication was 36.7% for silicone stent and 41.3% for SEMS and increased to 90.0% and 97.8% after 6 months, respectively, HR 1.66 (p=0.04). A competing risk of death analysis showed an adjusted HR of 1.41 (p=0.49) indicating no differences in overall complications between stents. Conclusions Both stents were equally successful and safe. The incidence of complications increased over time to 90% at 6 months for both stents. The risk of overall complications was higher for SEMS, nevertheless, when mortality was measured in a competitive risk analysis, no differences were found between SEMS and silicone stents.