Evaluating the Clinical Effectiveness of a Patient-specific Silicone Stent
Pulmonary Disease, Chronic Obstructive
About this trial
This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive
Eligibility Criteria
Inclusion Criteria: Patients will be considered for study inclusion if they have a clinical need for airway stenting defined by prior evidence of existing stents that have at least temporarily improved symptoms, but now suffer from stent complications; or those for whom a stent would be offered if an appropriate size and shape was available. Subjects must meet the following inclusion/exclusion criteria to be eligible for the study.
- Understand and voluntarily sign an informed consent form.
- Patients must be at least 22 years of age
- Patients must be able to undergo routine non-contrast CT scans of the chest
- Patient must be stable for general anesthesia and have an airway amenable to rigid bronchoscopy and stent implantation.
- The patients must have at least an expected 6 month survival.
- Patient must be able to maintain standard of care follow-up schedule and have access to standard of care medications and nebulizer machines and/or suction and oxygen as required for primary disease management.
- Patient must be able to personally provide consent and be able to describe Dyspnea and QOL and other patient-reported outcomes (PROs) required by study design
- Patient must require a stent that is within the design envelope of the patient-specific stents, as defined by COS (See Section 5.4 of this protocol for envelope)
Exclusion Criteria: Patients may be excluded if management of the airway problem can be safely and effectively treated with commercially available stents (SOC), non-stenting techniques, or surgical options.
- Patients may be excluded if the disease can be managed by simply removing prior stents or performing more conservative therapies.
- Chronic anticoagulant therapy that could limit the safety of performing rigid therapeutic bronchoscopy in a timely manner. (I.e. Plavix within one year of drug eluding cardiac stent (DES) or 6 weeks following bare metal coronary stent)
- Unstable cardiac disease
- Allergy to silicone
- Stenting to manage vascular compression syndromes.
- Multi-drug resistant bacterial or fungal chronic infections
- Emergent/urgent clinically indicated stent.
- Chronic/permanent mechanical ventilation.
- Pure Excessive Dynamic Airway Collapse (EDAC) patients.
- Pure Pulmonary Resistance (Rp) patients.
Sites / Locations
- Mayo ClinicRecruiting
- Pulmonary MedicineRecruiting
Arms of the Study
Arm 1
Experimental
Single-Arm Study
This is a prospective trial of the clinical utility of a patient-specific silicone stent implant for patients with complex airway disease, requiring an airway stent. The aim of this study is to observe the outcomes associated with the implants. Current stents have been suboptimal for treating benign stenosis of the airway and we are seeking to create a better treatment option. We hypothesize, based on the previous compassionate-use cases, that placing a patient-specific silicone stent will effectively alleviate symptoms associated with stenosis of the airway. The main measure of effectiveness will be patient-reported outcomes.