Airway Stents Placement & Removal

A lot of us are familiar with or have heard about stents used to open up blocked arteries. But did you know that stents can also be used to open up blocked airways?

What are Airway Stents?

The respiratory tract is made of hollow tubes and sacs that transport oxygen from our nose or mouth into our lungs where the exchange of gases takes place. If any part of the respiratory tract is blocked or narrowed, the whole process of breathing is affected. There are a number of respiratory conditions that can cause obstruction or narrowing of the airways such as lung cancer and tuberculosis. 

For normal breathing to be reinstated, the airways need to be reopened or recanalized. This is where airway stents come in. Airway stents are designed to keep the airway tubes open. It functions much like the stents used to keep blood vessels open so blood can flow freely. There are a number of characteristics necessary in an airway stent, these are:

• Easy to place and remove
• Large enough to stay in place
• Not too large to cause healing problems
• Flexible and must mimic natural bronchial tube structure
• Must not restrict mucus clearance

Airway stents can be made of different materials such as silicone and expendable metal mesh.

How do Airway Stents work?

Airway stents can be permanent or temporary and are inserted using the help of a bronchoscope, which is a long, thin tube that has a light and camera attached at one end. 

• An anaesthesia will be administered intravenously to help you relax and remove any discomfort you may feel. 
• A numbing medicine is sprayed onto the back of your throat.
• The bronchoscope is slowly and gently inserted into your nose or mouth and guided down your trachea (windpipe) and into your lower respiratory tract. 
• Once the bronchoscope reaches the site of obstruction, the stent is inserted and pushed down the bronchoscope.
• As the stent exits the bronchoscope, it opens and pushes the walls of the airway open.
• After the stent is released, the bronchoscope is slowly guided out.

There are instances where the airway is completely blocked, and a bronchoscope is unable to go through. When this happens, a balloon bronchoscopy is used to open the airways by inflating the balloon at the site of obstruction. Once the airway is opened, the balloon is deflated and removed, and the stent is inserted to maintain the open airways.

What happens after the placement of Airway Stents?

You may feel a bit groggy after the procedure, so you will be monitored for a few hours to ensure that you recover well. A chest x-ray might be performed after the bronchoscopy to ensure that no damage was done to your lungs and to ensure that the airway stents were placed properly.

Your throat might still feel numb from the numbing medicine so you will not be allowed to eat or drink until you recover. Your respiratory specialist will advise you on when you may return to your normal activities and diet. 

Who needs Airway Stents?

Airway stents are required when there are narrowed or obstructed airways. Airways become narrowed due to the following reasons:

• Lung cancer
• Tuberculosis
• Lung transplantation
• Bronchiolitis
• Pneumonia 

How do I prepare for Airway Stents placement in Singapore?

Before the procedure, you must avoid eating and drinking for 4 hours and you may be required to stop certain medications such as blood thinners and aspirin. Either a sedative or general anaesthesia may be used during the procedure, depending on your preference and advice of your respiratory specialist. 

What are the benefits of Airway Stents? 

• Stents have a range of rigidity
• Keeps airway open preventing collapse of the lungs
• Helps resist narrowing of the airways

What are the common possible complications and risks of Airway Stents placement or removal in Singapore?

There are minimal risks involved in placing or removing an airway stent, however, if they do occur, this is what to look out for:

• Adverse reaction to anaesthesia
• Migration or moving of the stent
• Granulation tissue formation around the stent, where the airway walls “engulf” the stent
• Inadequate mucus clearance
• Patient discomfort
• Problems with placement and removal of stents
• Stent breaking

Frequently asked questions