Airway stents or tracheobronchial prostheses refer to the tube shaped devices inserted into an airway and this process is referred to as interventional pulmonary or airway stenting. Airway stenting relieves airway obstruction due to the structures that are not suitable for reconstruction and resection. Tracheobronchial disorders are majorly caused due to the presence of benign or malignant tumors, post intubation tracheal injuries, extrinsic compression and tracheobronchomalacia post tracheostomy. Currently, there are two major types of airway stents available namely expandable metallic stents and silicon tube stents. Metallic stents are further classified as uncovered and fully covered forms. Metal stents can be inserted with the help of a flexible bronchoscope while silicon stents are placed with the help of a rigid bronchoscope when the patient in under general anesthesia. Primarily, removable stents are preferred in case of the treatment for benign disorders.
The treatment of primary and metastatic lung cancer is the most common condition treated with the help of airway stents rendering an unobstructed airway. Other indications include primary airway tumors, thyroid cancer, inflammatory lesions, vascular compression, head and neck tumors, oesophageal cancer, idiopathic benign tracheal stenonsis and others. This process ensures durable palliation in unresectable patients with central airway obstruction and there is a need for frequent multiple procedures and stents to maintain unobstructed airway.
The choice of stent depends on the type of lesion to be treated, resource availability and in the presence of a dedicated operator. Proper stent sizing can be achieved by reviewing the computed tomography images and other methods. The length is a stent to be used is a very critical parameter to be considered in order to ensure proper functioning of these stents. For instance, if the diameter if these stents is too small than the size if the lesion, then they might migrate from its original position and of the length of the stent is too large, it might cause stress on the airway wall, hence, the length of the stent should exceed the length of the lesion to some degree. Migration of the stent results in several side effects such as breakage of metal fibers, granuloma formation, hemoptysis and pain.
The placement of the stent should be avoided in case of a non-viable lung. Placement of the stent should be performed by highly trained pulmonologists. It is mandate for the trainees to perform atleast 20 supervised procedures in order to establish a basic competency and to maintain the competency these operators should perform more than 10 procedures per year and furthermore these operators should be proficient in placement of both silicone and flexible stents.
The market for airway stents can be segmented by type and applications. Metallic and silicone stents are the two major types of airway stents available commercially. Factors such as patient safety, proficiency in stent placement and other regulatory policies govern the market growth. Geographically, North America and Europe regions are the major revenue contributors to this market majorly due to increasing incidence of lung cancers and high disposable incomes. Asia Pacific and Rest of the World provide lucrative business opportunities in this area owing to the large patient population and improved healthcare facilities.
The major factors favoring the airway stent market are consistent increase in lung cancer incidence worldwide and development of novel and efficient stents to treat airway disorders. On the other hand factors such as lack of trained operators and side effects caused due to migration of the stents might hamper the acceptance thereby affecting the market growth. Novatech SA, Boston Medical Products, Inc., Boston Scientific Corporation, TAEWOONG Medical Co., Ltd. constitute some of the companies operating in this market.
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