Bronchoscopic removal difficult and risky
On the other hand, SEMs are also notorious for various troublesome complications, including stent fracture, migration, impaired mucociliary clearance, and increased bacterial infection. Additionally, the embedded nature of the stent makes subsequent bron-choscopic removal difficult and risky. We believe that an ideal airway stent should (1) possess sufficient strength to perform its mechanical function, (2) be biodegradable (no need for removal after serving its purpose), (3) be biocompatible so that the material breakdown process will not cause any tissue irritation, and/or (4) provide effective pharmaceuticals for a sustained period of time.
Endobronchial intratumoral chemotherapy (EITC) (ie, the injection of conventional cytotoxic
directly into the tumor tissue through a flexible bronchoscope) has been described in several clinical studies with encouraging results. Local high doses of cytotoxic action can reduce large local tumor cell burdens, with rapid alleviation of endobronchial obstruction. Furthermore, unlike conventional IV chemotherapy, EITC exhibits no significant systemic toxicity. However, such drug delivery was transient and could be prolonged for only a few hours to days in the gel-form or oil-form injection. Hence, the clinical indication was only limited to cases of asymptomatic endobronchial tumors with < 50% obstruction.
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In our laboratory, we had successfully designed and fabricated a mesh-type, biodegradable stent with a backbone of polycaprolactone (PCL) that permitted airway remodeling in rabbits. In this report, following our previous work, we aimed to develop biodegradable drug-eluting stents that can provide a sustainable release of cisplatin, which is the most commonly used antitumor medication in lung cancer for the treatment of malignant tracheal obstruction. An elution method and a high-performance liquid chromatography (HPLC) analysis were used to determine the in vitro release of cisplatin from the biodegradable stents. In addition, the stents were surgically implanted into the cervical trachea of 15 rabbits. The level of cisplatin by in vivo release in the trachea, lung, and blood were analyzed weekly. Histologic examination was also performed. Looking for cheap medications?