Cross-Linked Hyaluronan-Coated Stents in the Prevention of Airway Stenosis

Abstract

OBJECTIVE: This project studies the use of airway stents coated with a cross-linked derivative of hyaluronan (HA) in a rabbit airway model of subglottic stenosis (SGS).

STUDY DESIGN AND SETTING: An acute subglottic mucosal injury and airway stent placement design were used in a rabbit model. Thirty-six rabbits were randomized to 6 different study groups. Four groups had the subglottic mucosa denuded at the cricoid, and 2 groups received no injury. Airway stents coated with Carbylan-SX, a cross-linked derivative of HA, and controls were placed for 3 weeks. After sacrifice at 6 weeks, morphometric measurements of subglottic lumen were taken.

RESULTS: In posttraumatic models, no significant differences were seen in airway area measures between groups (P = 0.86). In non-injury groups, a significant difference between Carbylan-SX versus non—HA-derivative-coated stents was seen (P = 0.05).

CONCLUSION: In this model of acute subglottic mucosal injury, the HA-derivative—coated stent did not improve healing. However, in the absence of mucosal injury, the Carbylan-SX film—coated stent yielded significantly larger airway areas compared with a noncoated stent.

SIGNIFICANCE: Stents or endotracheal tubes coated with a cross-linked derivative of HA may prevent stenosis in patients without airway injury but require long-term intubation or laryngotracheal stenting.