Cross-linked hyaluronan-coated stents in the prevention of airway stenosis
Presented at the Research Forum of the American Academy of Otolaryngology/Head and Neck Surgery Foundation, Los Angeles, CA, September 27, 2005, and won the 2005 ARO Research Forum Medical Student Research Award.
Objective
This project studies the use of airway stents coated with a cross-linked derivative of hyaluronan (HA) in a rabbit airway model of subglottic stenosis (SGS).
Study design and setting
An acute subglottic mucosal injury and airway stent placement design were used in a rabbit model. Thirty-six rabbits were randomized to 6 different study groups. Four groups had the subglottic mucosa denuded at the cricoid, and 2 groups received no injury. Airway stents coated with Carbylan-SX, a cross-linked derivative of HA, and controls were placed for 3 weeks. After sacrifice at 6 weeks, morphometric measurements of subglottic lumen were taken.
Results
In posttraumatic models, no significant differences were seen in airway area measures between groups (P = 0.86). In non-injury groups, a significant difference between Carbylan-SX versus non–HA-derivative-coated stents was seen (P = 0.05).
Conclusion
In this model of acute subglottic mucosal injury, the HA-derivative–coated stent did not improve healing. However, in the absence of mucosal injury, the Carbylan-SX film–coated stent yielded significantly larger airway areas compared with a noncoated stent.
Significance
Stents or endotracheal tubes coated with a cross-linked derivative of HA may prevent stenosis in patients without airway injury but require long-term intubation or laryngotracheal stenting.
aUniversity of Utah School of Medicine, The University of Utah, Salt Lake City, Utah
bDivision of Otolaryngology/Head and Neck Surgery, The University of Utah, Salt Lake City, Utah
cDepartment of Medicinal Chemistry and Center for Therapeutic Biomaterials, The University of Utah, Salt Lake City, Utah
Reprint requests: Marshall E. Smith, MD, Division of Otolaryngology/Head and Neck Surgery, 3C-120 SOM, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132.
Dr Prestwich is has 5% equity and is Senior Scientific Advisor and Chair of the Scientific Advisory Board for Carbylan BioSurgery, Inc., a venture capital–funded startup that will commercialize applications of Carbylan biomaterials for human therapeutic use. He is also a consultant and member of the Scientific Advisory Board for Aeterna-Zentaris, which acquired his previous startup company Echelon Biosciences, which sold lipid reagents and lipid signaling therapies.
Supported by a Financial Incentive Seed Grant from The University of Utah Research Foundation, the Center for Therapeutic Biomaterials (a member of the Utah Centers of Excellence program), NIH Grant R01 DC4336 from the National Institute on Deafness and other Communicative Disorders (NIDCD), and NIH Grant T35 HL07744 from the National Heart Lung and Blood Institute (NHLBI).
ABSTRACT