Using individualized three-dimensional printed airway models to guide airway stent implantation

Jesse Xu*, Cameron Sullivan, Hui Xin Ong, Jonathan P. Williamson, Daniela Traini, Nicole Hersch, Michael Byrom, Paul M. Young

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Airway stents are used to manage central airway obstructions by restoring airway patency. Current manufactured stents are limited in shape and size, which pose issues in stent fenestrations needed to be manually created to allow collateral ventilation to airway branches. The precise location to place these fenestrations can be difficult to predict based on 2-dimensional computed tomography images. Inspiratory computed tomography scans were obtained from 3 patients and analysed using 3D-Slicer™, Blender™ and AutoDesk® Meshmixer™ programmes to obtain working 3D-airway models, which were 3D printed. Stent customizations were made based on 3D-model dimensions, and fenestrations into the stent were cut. The modified stents were then inserted as per usual technique. Two patients reported improved airway performance; however, stents were later removed due to symptoms related to in-stent sputum retention. In a third patient, the stent was removed a few weeks later due to the persistence of fistula leakage. The use of a 3D-printed personalized airway model allowed for more precise stent customization, optimizing stent fit and allowing for cross-ventilation of branching airways. We determine that an airway model is a beneficial tool for stent optimization but does not prevent the development of some stent-related complications such as airway secretions.

Original languageEnglish
Pages (from-to)900-903
Number of pages4
JournalInteractive Cardiovascular and Thoracic Surgery
Volume31
Issue number6
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Airway stents
  • 3D printing
  • Tracheobronchomalacia
  • Excessive dynamic airway collapse
  • Airway model
  • Personalization
  • Stent fenestrations

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