Airway stent associated respiratory tract infections

: Airway stenting is effective in alleviating symptoms from airway obstruction, but comes with multiple complications. The most common complications include mucous plugging, stent migrations, granulation tissue and respiratory tract infections. Stent migrations are usually seen early, whereas granulation tissue and respiratory tract infections are later complications. Airway stent associated lower respiratory tract infection (LRTI) is a negative prognostic factor in terms of survival and is important to identify and treat in a timely fashion to reduce mortality and morbidity. These infections also increase hospital length of stays and healthcare costs, further making it a topic of interest. There is significant heterogeneity in the definition of stent related respiratory infections, leading to variability in reported incidence. Another factor might be the heterogeneity of the type of stents used in these studies and large trials are lacking. Some measures done in an attempt to decrease infection rate, include chest imaging, surveillance bronchoscopy and even prophylactic antibiotics, all with minimal to no data. The aim of this review is to summarize the current evidence on the epidemiology, pathogenesis, diagnosis, prevention, and treatment of airway stent infections and colonization. Future directions for airway stents include drug eluding stents, with cisplatin, paclitaxel, and mitomycin C, among others. Biodegradable and 3D stents are also being studied with encouraging data.