Henry Bauer and Viviana Martinez Airway Stents Henry Bauer and Viviana Martinez

Lung Cancer Lung cancer – uncontrollable growth of abnormal cells in the lung(s) form masses of tissue or tumors Malignant can spread to nearby tissues or other organs 2 main types -Non-Small Cell Lung Cancer -Small Cell Lung Cancer In 2009 - 205, 974 people were diagnosed with lung cancer -158, 081 people died from lung cancer

Lung Cancer Non-Small Cell Lung Cancer is most common Accounts for ~85% of all diagnoses Four stages: Stage 1: cancer is localized to lungs Stage 2: cancer has spread to nearby lymph nodes Stage 3: cancer has spread to lymph nodes in the middle of the chest Stage 4: advanced disease; cancer has spread to both lungs, fluid around the lungs, and/or to other tissues and organs Small Cell Lung Cancer 2 stages: Limited: cancer in one part of a single lung plus nearby lymph nodes Extensive: cancer has spread throughout the chest, other tissues, and organs

Symptoms Damage to the lungs and surrounding tissues/structures Persistent and/or worsening cough Coughing up blood Wheezing or shortness of breath Chronic pneumonia or bronchitis Chest pain Fatigue

Risk Factors Smoking ( #1 cause) or second hand smoke Tuberculosis or other lung diseases Environmental exposure to carcinogens such as asbestos, diesel exhaust, and radon Age Family history

Treatment Surgery – remove lobe/section of lung with tumor Chemotherapy – drugs are used to shrink or kill the cancer Carboplatin, Cisplatin Radiation Targeted drug therapy – drugs specifically target cancer cells Tarceva, Avastin, Xalkori

Airway Stents

Types of Stents EGIS Airway Stent drawstring for easy removal polishing process removes micro cracks non-biodegradable silicone membrane Nitinol for shape memory and superelasticity barbs prevent migration available in a variety of types and sizes (diameters and lengths)

What makes it the best choice? Use stent after chemotherapy and radiation treatment fail to remove blockage. Helps patients undergoing mechanical ventilation to breath unassisted. Restore collapsed airway. rapid relief for symptoms

Costs Surgery costs $5000 Individual stents can be $1000-2000. Median cost of removal surgery is $10,700.

Implantation Protocols Sedation and bronchoscopy Insert guidewire and sizing catheter to measure size of obstruction. Insert breathing tube to allow airflow during insertion. Deploy stent. Secure stent placement.

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Recovery and Patient Followup Symptoms improve in 84% of patients within 24 hours Bronchoscopy check ups. Monitor for coughing, shortness of breath, etc. Doesn’t require immunosupressants Long term complications can require additional surgery

Complications Migration of stent. Trouble breathing. Bleeding. Pneumonia or other infection. New airway obstruction from accumulated secretions or tumor growth. Stent fracturing.

Conclusion EGIS airway stent provides rapid relief of symptoms and drastically improves quality of life for patients. Provides time for chemotherapy or drugs to take effect, or for conditions to improve and allow for surgery. Despite potential complications, airway stents have proven to be versatile and effective.

http://www.nytimes.com/2013/04/30/science/groundbreaking-surgery-for-girl-born-without-windpipe.html?emc=eta1&_r=0