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Kim TH, Heo SY, Oh GW, Park WS, Jung WK. Biocompatibility and sub-chronic toxicity studies of phlorotannin/polycaprolactone coated trachea tube for advancing medical device applications. Sci Rep 2024; 14:3945. [PMID: 38365854 PMCID: PMC10873353 DOI: 10.1038/s41598-024-54684-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/15/2024] [Indexed: 02/18/2024] Open
Abstract
The phlorotannin-polycaprolactone-coated endotracheal tube (PP tube) has been developed with the aim of preventing tracheal stenosis that can result from endotracheal intubation, a factor that can lead to a serious airway obstruction. Its preventive efficacy has been assessed through both in vitro and in vivo investigations. However, there is a lack of studies concerning its biocompatibility and sub-chronic toxicity in animal models, a crucial factor to ensure the safety of its usage as a functional endotracheal tube. Thus, this study aimed to evaluate the biocompatibility and sub-chronic (13 weeks) toxicity of the PP tube through L929 cell line and diverse in vivo models. The cytotoxicity testing was performed using the extracts of PP tube on L929 cells for 72 h. Furthermore, other tests conducted on animal models, including ICR mice (acute systemic toxicity), New Zealand white rabbit (intradermal reactivity and pyrogen tests), guinea pig (maximization sensitization), and Sprague Dawley rats (sub-chronic toxicity). In both biocompatibility and sub-chronic toxicity analyses, no significant adverse effects are observed in the groups exposed to the PP tube, when compared to control group. Altogether, the findings suggested that the PP tube exhibits relative non-toxic and safety, supporting its suitability for clinical usage. However, extended periods of intubation may produce mild irritant responses, highlighting the clinical caution of limiting intubation duration to less than 13 weeks.
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Affiliation(s)
- Tae-Hee Kim
- Research Center for Marine-Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
| | - Seong-Yeong Heo
- Jeju Bio Research Center, Korea Institute of Ocean Science and Technology (KIOST), Jeju, 63349, Republic of Korea
| | - Gun-Woo Oh
- National Marine Biodiversity Institute of Korea, Seochun, Chungcheongnam-do, 33662, Republic of Korea
| | - Won Sun Park
- Department of Physiology, Kangwon National University School of Medicine, Chuncheon, 24341, Republic of Korea
| | - Won-Kyo Jung
- Research Center for Marine-Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea.
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea.
- Major of Biomedical Engineering, Division of Smart Healthcare, College of Information Technology and Convergence and New-Senior Healthcare Innovation Center (BK21 Plus), Busan, 48513, Republic of Korea.
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Xu C, Ma Y, Huang H, Ruan Z, Li Y. A Review of Woven Tracheal Stents: Materials, Structures, and Application. J Funct Biomater 2022; 13:jfb13030096. [PMID: 35893464 PMCID: PMC9326637 DOI: 10.3390/jfb13030096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The repair and reconstruction of tracheal defects is a challenging clinical problem. Due to the wide choice of materials and structures, weaving technology has shown unique advantages in simulating the multilayer structure of the trachea and providing reliable performance. Currently, most woven stent-based stents focus only on the effect of materials on stent performance while ignoring the direct effect of woven process parameters on stent performance, and the advantages of weaving technology in tissue regeneration have not been fully exploited. Therefore, this review will introduce the effects of stent materials and fabric construction on the performance of tracheal stents, focusing on the effects of weaving process parameters on stent performance. We will summarize the problems faced by woven stents and possible directions of development in the hope of broadening the technical field of artificial trachea preparation.
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Affiliation(s)
- Chen Xu
- College of Textiles, Donghua University, Shanghai 201620, China; (C.X.); (Y.M.)
| | - Yanxue Ma
- College of Textiles, Donghua University, Shanghai 201620, China; (C.X.); (Y.M.)
| | - Haihua Huang
- Department of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China;
| | - Zheng Ruan
- Department of Thoracic Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China;
- Correspondence: (Z.R.); (Y.L.)
| | - Yuling Li
- College of Textiles, Donghua University, Shanghai 201620, China; (C.X.); (Y.M.)
- Correspondence: (Z.R.); (Y.L.)
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3
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Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis. J Clin Med 2022; 11:jcm11030517. [PMID: 35159969 PMCID: PMC8836604 DOI: 10.3390/jcm11030517] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Airway stent implantation used in the treatment of benign cicatricial airway stenosis (BCAS) can lead to local granulation and scar formation, resulting in restenosis and treatment failure. Methods: We systematically investigated a paclitaxel-loaded PLGA-coating stent (PLPCS) and analyzed the safety and efficacy of the PLPCS in patients with BCAS. Patients were enrolled from four hospitals in China and observed for six months after implantation, by bronchoscopy performed weekly in the first month and monthly thereafter. The stent was removed immediately upon detection of granulation tissue proliferation, leading to immobility of the stent. Results: Granulation tissue was formed one week after stent implantation, most of which was located at the upper edge of the stent and the narrowest airway in the stent. All stents were removed in three months (mean: 6.51 + 4.67 weeks), with a curative outcome in one case and ineffective results in two. The remaining seven patients developed complications within three months, necessitating early stent removal. The main complication was granulation formation, resulting in difficulty in stent removal. Conclusion: Although PLPCS showed beneficial effects in basic and animal experiments, it cannot prevent airway restenosis in actual practice, mainly due to granulation formation.
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Johnson CM, Luke AS, Jacobsen C, Novak N, Dion GR. State of the Science in Tracheal Stents: A Scoping Review. Laryngoscope 2021; 132:2111-2123. [PMID: 34652817 DOI: 10.1002/lary.29904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/12/2021] [Accepted: 09/23/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Recent material science advancements are driving tracheal stent innovation. We sought to assess the state of the science regarding materials and preclinical/clinical outcomes for tracheal stents in adults with benign tracheal disease. METHODS A comprehensive literature search in April 2021 identified 556 articles related to tracheal stents. One-hundred and twenty-eight full-text articles were reviewed and 58 were included in the final analysis. Datapoints examined were stent materials, clinical applications and outcomes, and preclinical findings, including emerging technologies. RESULTS In the 58 included studies, stent materials were metals (n = 28), polymers (n = 19), coated stents (n = 19), and drug-eluting (n = 5). Metals included nitinol, steel, magnesium alloys, and elgiloy. Studies utilized 10 different polymers, the most popular included polydioxanone, poly-l-lactic acid, poly(d,l-lactide-co-glycolide), and polycaprolactone. Coated stents employed a metal or polymer framework and were coated with polyurethane, silicone, polytetrafluoroethylene, or polyester, with some polymer coatings designed specifically for drug elution. Drug-eluting stents utilized mitomycin C, arsenic trioxide, paclitaxel, rapamycin, and doxycycline. Of the 58 studies, 18 were human and 40 were animal studies (leporine = 21, canine = 9, swine = 4, rat = 3, ovine/feline/murine = 1). Noted complications included granulation tissue and/or stenosis, stent migration, death, infection, and fragmentation. CONCLUSION An increasing diversity of materials and coatings are employed for tracheal stents, growing more pronounced over the past decade. Though most studies are still preclinical, awareness of tracheal stent developments is important in contextualizing novel stent concepts and clinical trials. Laryngoscope, 2021.
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Affiliation(s)
- Christopher M Johnson
- Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center-San Diego, San Diego, California, U.S.A
| | - Alex S Luke
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A
| | | | - Nicholas Novak
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, U.S.A
| | - Gregory R Dion
- Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A.,Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A
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Virot E, Marcot C, Vergnon JM, Matau C, Porzio M, Kessler R. Airway stent current practices evaluation: Survey among French bronchoscopy practitioners. Respir Med Res 2020; 77:89-94. [PMID: 32492650 DOI: 10.1016/j.resmer.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 01/14/2020] [Accepted: 02/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Airway stenting (AS) is performed for the treatment of benign or malignant central airway stenosis. In France, more than 30 centers practice AS. The aim of this survey was to evaluate the current practice around airway stenting among French bronchoscopy practitioners. METHOD We performed an online survey sent to the GELF group (Groupe d'Endoscopie de Langue Française) mailing list. The first part comprised 10 questions about the different attitudes before AS and the second part included 10 questions about the management after AS. RESULTS Thirty-six participants answered to the first part of the questionnaire and thirty-three to the second. There were some similarities, for example the absence of prophylactic antibiotic treatment before procedure (86%), use of saline nebulization, and removing or replacing the airway stent in case of persistent chest congestion or infection (73%). We also noted an important heterogeneity of the practices with several differences concerning systematic endoscopic control, bacteriological sampling before procedure (44%) and systematically AS replacement. CONCLUSION This survey shows that AS management in France varies between practitioners. Respondents agreed on a few points, but disagreed on several important aspects of the management. These results emphasize the need of expert recommendations to improve AS management.
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Affiliation(s)
- E Virot
- Respiratory Disease Department, Strasbourg University Hospital, Strasbourg, France.
| | - C Marcot
- Respiratory Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - J-M Vergnon
- Department of Pulmonology, University Hospital of Saint-Étienne, 42000 Saint-Étienne, France
| | - C Matau
- Respiratory Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - M Porzio
- Respiratory Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - R Kessler
- Respiratory Disease Department, Strasbourg University Hospital, Strasbourg, France
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Lee HS, Jeong M, Ko S, Heo S, Kang HW, Kim SW, Hwang CW, Lee KD, Oak C, Jung MJ, Oh J, Park WS, Choi I, Jung W. Fabrication and biological activity of polycaprolactone/phlorotannin endotracheal tube to prevent tracheal stenosis: An in vitro and in vivo study. J Biomed Mater Res B Appl Biomater 2019; 108:1046-1056. [DOI: 10.1002/jbm.b.34456] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/30/2019] [Accepted: 07/17/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Hyoung Shin Lee
- Department of Otolaryngology‐Head and Neck SurgeryKosin University College of Medicine Busan Republic of Korea
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
| | - Min‐Seon Jeong
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
- Department of Biomedical Engineering and Center for Marine‐Integrated Biomedical TechnologyPukyong National University Busan Republic of Korea
| | - Seok‐Chun Ko
- National Marine Bio‐Resources and Information CenterNational Marine Biodiversity Institute of Korea Seochun Chungcheongnam‐do Republic of Korea
| | - Seong‐Yeong Heo
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
- Department of Biomedical Engineering and Center for Marine‐Integrated Biomedical TechnologyPukyong National University Busan Republic of Korea
| | - Hyun Wook Kang
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
- Department of Biomedical Engineering and Center for Marine‐Integrated Biomedical TechnologyPukyong National University Busan Republic of Korea
| | - Sung Won Kim
- Department of Otolaryngology‐Head and Neck SurgeryKosin University College of Medicine Busan Republic of Korea
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
| | - Chi Woo Hwang
- Department of Molecular BiologyKosin University College of Medicine Busan Republic of Korea
| | - Kang Dae Lee
- Department of Otolaryngology‐Head and Neck SurgeryKosin University College of Medicine Busan Republic of Korea
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
| | - Chulho Oak
- Department of Internal MedicineKosin University College of Medicine Busan Republic of Korea
| | - Min Jung Jung
- Department of PathologyKosin University College of Medicine Busan Republic of Korea
| | - Junghwan Oh
- Department of Otolaryngology‐Head and Neck SurgeryKosin University College of Medicine Busan Republic of Korea
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
| | - Won Sun Park
- Department of PhysiologyKangwon National University, School of Medicine Chuncheon Gangwon Republic of Korea
| | - Il‐Whan Choi
- Department of MicrobiologyInje University College of Medicine Busan Republic of Korea
| | - Won‐Kyo Jung
- Marine‐Integrated Bionics Research CenterPukyong National University Busan Republic of Korea
- Department of Biomedical Engineering and Center for Marine‐Integrated Biomedical TechnologyPukyong National University Busan Republic of Korea
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Sapalidis K, Laskou S, Amaniti A, Koulouris C, Giannakidis D, Mantalovas S, Karapantzos I, Karapantzou C, Zarogoulidis P, Arapakis I, Huang H, Bai C, Kougioumtzi I, Katsikogiannis N, Sarika E, Konstantinou F, Hohenforst-Schmidt W, Kesisoglou I. New hybrid method for trachea dilatation with rigid and flexible tools. Respir Med Case Rep 2018; 24:65-73. [PMID: 29977763 PMCID: PMC6010631 DOI: 10.1016/j.rmcr.2018.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 11/29/2022] Open
Abstract
Trachea stenosis is observed either in benign or malignant situations. In cancer malignancy a tumor might obstruct the central airway in three different ways. Again granuloma tissue is usually observed after intubation or stent placement in order to manage a benign malformation of the trachea. In any case there are several tools and techniques that can be used either with surgery or endoscopically to manage such situation. We will focus on a hybrid technique in order to ventilate the patient while performing endoscopic management of granuloma tissue.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stella Laskou
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Aikaterini Amaniti
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitrios Giannakidis
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalovas
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Ilias Karapantzos
- Ear, Nose and Throat Department, ``Saint Luke`` Private Hospital, Thessaloniki, Panorama, Greece
| | - Chrysa Karapantzou
- Ear, Nose and Throat Department, ``Saint Luke`` Private Hospital, Thessaloniki, Panorama, Greece
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, ``Theageneio`` Cancer Hospital, Thessaloniki, Greece
| | - Iakovos Arapakis
- Ear, Nose and Throat Department, ``Saint Luke`` Private Hospital, Thessaloniki, Panorama, Greece
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ioanna Kougioumtzi
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Katsikogiannis
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Eirini Sarika
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Fotis Konstantinou
- Thoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology, "Hof" Clinics, University of Erlangen, Hof, Germany.,Sana Clinic Group Franken, Department of Pulmonology, "Hof" Clinics, University of Erlangen, Hof, Germany.,Sana Clinic Group Franken, Department of Intensive Care, "Hof" Clinics, University of Erlangen, Hof, Germany.,Sana Clinic Group Franken, Department of Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Isaak Kesisoglou
- 3rd Department of Surgery, ``AHEPA`` University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
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