Juan Anton-Pacheco

and 7 more

Introduction The aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children focusing on effectiveness and safety, and to analyse the factors involved in the different outcomes observed. Materials and methods Retrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication , clinical baseline, stent size, location, complications, clinical outcome, and time of follow-up. Statistical analyses were performed in order to detect the eventual contribution of variables in the different outcomes observed. Results 54 PDO stents were placed in 26 patients (median age, 4 m). All showed severe symptoms of central airway obstruction due to: tracheomalacia 9 patients, bronchomalacia 5, tracheobronchomalacia 10, and tracheal stenosis 2. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in main bronchi. 53,8% of patients needed successive stenting and all exhibited comorbidities. Complete clinical resolution was observed in 8 cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsen in one. Age had a significant positive impact in outcome (6 months vs 3 m.; p=0.024). Additionally, smaller stents were associated with a better outcome (20 vs 26 mm; p=0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow-up was complete in survivors (median, 58 m). Conclusions PDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent-related granulation tissue continues to be a relevant matter of concern. This issue together with increased degradation times deserve further research.