Custom-made stents offer patients breathing relief
Researchers in France have developed custom-made silicone stents to open up blocked airways in patients with breathing problems, offering hope to people for whom conventional stents fail.
The prostheses are anatomically identical to the patients’ own tracheae or bronchi and are an example of how personalised medicine is making inroads into the medical device arena, said oncologist-pulmonologist Julien Mazières, who is working with a team at Toulouse University Hospital that developed the tailor-made implants in collaboration with the Toulouse-based start-up Anatomik Modeling.
“Every person could [ultimately] have their own stent, even if it is not a complicated case. It would be better than what is commercially available [at present],” said Mazières.
While standard stents are suitable for most patients with narrowing of their large airways, the devices fail in a significant minority of those who have had lung transplants, tracheotomies or have tracheal diseases.
CLINICAL TRIAL
Standard stents can move out of place, perforate tissue, or cause inflammation that leads to further disease, said Nicolas Guibert, a pulmonologist on the team at the hospital. He presented the results from a small clinical trial involving patients in whom all conventional treatments had failed at the EuroScience Open Forum 2018, currently under way in Toulouse.
Nine patients were fitted with the new-generation devices and monitored for a year.
In all but one of the patients, the close fit between the personalised breathing device and their own airways provided immediate improvement in their symptoms and quality of life, said Guibert.
The ninth patient’s device did not fit properly.
The customised stents are created with computer-aided design: CT-scan images are used to make a 3D virtual reconstruction of the patient’s unique airways, which is used to create a mould.
A tailor-made prosthesis is then manufactured.
The process, which has been patented, takes between three and five weeks, said Guibert.