Porcine small intestinal submucosa (SIS) may be useful for treating long-segment congenital tracheal stenosis.1
A team of researchers from Texas A&M University and the Cincinnati Children’s Hospital found that SIS performed better than bovine pericardium in an in vivo ovine model of tracheal repair.
Congenital tracheal stenosis (CTS) is a rare disease.2 Long-segment CTS (LSCTS) involves more than 30% of the trachea and presents with complete cartilage rings (unlike the normal C-shaped rings) and no posterior muscular membranous wall.1
Current standards for treatment of LSCTS include slide and patch tracheoplasties, but both treatments carry the risk of serious complications.
Karkhanis et al. evaluated the use of SIS to treat surgically created large tracheal defects in a growing lamb model. The control was bovine pericardium, which is routinely used in patch tracheoplasties.
Eight months after implantation, the SIS patch used for tracheal repair was epithelialized with mucin, secretory goblet cells, and fully formed cilia. There was no collapse of the trachea or formation of granulation tissue. There was no sign of cartilage regeneration; however, the authors suggested that the study was too short for complete remodeling to occur. The control animals both died from respiratory failure.
The authors felt these results support additional testing with an increased number of animals and longer study duration.
1Karkhanis T, Byju AG, Morales DL, Zafar F, Haridas B. Composite biosynthetic graft for repair of long-segment tracheal stenosis: a pilot in vivo and in vitro feasibility study. ASAIO J. Published online January 3, 2024.
2Antón-Pacheco JL, Morante R. Operative or non-operative treatment of congenital tracheal stenosis: is there something new? J Thorac Dis. 2017;9(12):4878–4880.