Germans Trias Hospital, pioneer in implanting personalized tracheobronchial prostheses

The Germans Trias Hospital has reached a relevant medical milestone by becoming one of the first centers in Europe to implant a personalized tracheobronchial prosthesis in a patient.

Tracheobronchial prostheses are tubular structures made of silicone, which have been used since the nineties to keep the lumen of the trachea and the main bronchi open when, for different reasons, an occlusion occurs in this main airway that prevents the free circulation of air in the lungs. However, these prostheses are straight and have predefined dimensions, something that makes it difficult for them to adapt to the complex anatomies of certain patients.

Custom prosthetics with 3D printing

However, from now on and thanks to the innovation represented by 3D printing, personalized prostheses adaptable to the anatomy of each patient are now available. Thus, based on a three-dimensional digital reconstruction of the patient’s tracheobronchial tree – which is obtained through a chest CT scan – a custom mold is designed and manufactured with a 3D printer. From this the silicone prosthesis is manufactured, which is implanted using a rigid bronchoscopy, in a procedure that requires great precision in its placement.

This is what the hospital’s Interventional Pulmonology team led by Antoni Rosell, Clinical Director of the Thorax area, did to a patient who, although an attempt was made to implant a standard prosthesis more than a year ago, it did not fit his anatomy well enough. and had to withdraw, suffering progressive suffocation until he could only make minimal efforts. Now, with the new customized prosthesis already implanted, these symptoms have disappeared. In a year or two it will be evaluated whether the prosthesis has managed to sufficiently dilate the stricture and whether it can be permanently removed.

This patient’s case is an example of what this objective entails: an important step to treat patients with complex tracheobronchial stenosis who cannot be operated on surgically, and who until now had limited therapeutic options.

This type of stenosis affects patients of all ages, and can be of malignant origin (such as lung or esophageal cancer) or benign. In the latter cases, we are talking about inflammations caused by difficult intubations (due to traffic accidents, for example), by radiotherapy, by infections such as tuberculosis or by unknown causes.

In all cases, the inflammation, once healed, leaves a scar that reduces air passage and makes breathing difficult, something that only surgery or prosthesis can solve. Although standard prostheses continue to have indications, the plan is to intensify the placement of personalized prostheses, especially in complex stenosis of benign cause, which is estimated to be a dozen per year in Catalonia.

The Interventional Pulmonology team at the Germans Trias Hospital is recognized for its experience in tracheobronchial prostheses and actively participates in the development of international guidelines on their use in malignant and benign pathologies, and carries out studies in animal models to improve results and reduce complications.

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