Current Practice of Airway Stenting in the Adult Population in Europe: A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)Dutau H.1 · Breen D.2 · Bugalho A.3 · Dalar L.4 · Daniels J.5 · Dooms C.6 · Eberhardt R.7 · Ek L.8 · Encheva M.9 · Febvre M.10 · Hackl M.11 · Marran S.12 · Papai-Szekely Z.13 · Perch M.14 · Roglic M.15 · Rosell A.16 · Rozman A.17 · Shah P.L.18 · Simon M.19 · Szlubowski A.20 · Stratakos G.21 · Sundset A.22 · Uibu T.23 · Von Garnier C.24 · Zaric B.25 · Zdraveska M.26 · Zuccatosta L.27 · Bokan D.28 · Arshad Husain S.29 · Bilaceroglu S.30 · Gasche-Soccal P.31 · Gasparini S.27 · Herth F.J.F.7 · Munavvar M.32
1Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, North Hospital of Marseille, Aix-Marseille University, Marseille, France; 2Interventional Respiratory Unit, Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland; 3Pulmonology Department, CUF Infante Santo Hospital and CUF Descobertas Hospital, and Chronic Diseases Research Center, NOVA Medical School, Lisbon, Portugal; 4Department of Pulmonary Medicine, School of Medicine, Istanbul Bilim University, Istanbul, Turkey; 5Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands; 6Department of Respiratory Diseases, University Hospitals KU Leuven, on behalf of the Thoracic Endoscopy Working Group of the Belgian Society for Pulmonology, Leuven, Belgium; 7Department of Pulmonology and Critical Care Medicine, Thoraxklinik, University of Heidelberg and Translational Lung Research Center Heidelberg (TLRCH), German Center for Lung Research (DZL), Heidelberg, Germany; 8Department of Heart and Lung Diseases, Skåne University Hospital, Lund, Sweden; 9Clinic of Pulmonary Diseases, Military Medical Academy, Sofia, Bulgaria; 10Pulmonology Department, Hôpital Tenon, AP-HP, Paris, France; 11Department of Pulmonology, Landeskrankenhaus - Universitätskliniken Innsbruck, Innsbruck, Austria; 12Department of Endoscopy, North Estonia Medical Centre, Tallinn, Estonia; 13Fejér Megyei Szent György Kórház, Székesfehérvár, Hungary; 14Department of Cardiology, Section for Lung Transplantation and Respiratory Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 15Department for Lung Diseases Jordanovac, University Hospital Centre Zagreb, Zagreb, Croatia; 16Servei de Pneumologia, Hospital Universitari de Bellvitge, Idibell, Ciberes, Universitat de Barcelona, Barcelona, Spain; 17Department of Respiratory Endoscopy/Interventional Pulmonology, University Clinic Golnik, Golnik, Slovenia; 18Royal Brompton & Harefield NHS Foundation Trust, and Imperial College, London, UK; 19Bronchoscopy Department, Pulmonology Clinic, Cluj-Napoca, Romania; 20Endoscopy Unit, John Paul II Hospital, Krakow, Poland; 21Interventional Pulmonology Unit, 1st Respiratory Medicine Department, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece; 22Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 23Department of Respiratory Diseases, Tampere University Hospital, Tampere, Finland; 24Respiratory Medicine, Inselspital, University of Bern, Bern, Switzerland; 25Institute for Pulmonary Diseases of Vojvodina, Clinic for Thoracic Oncology, University of Novi Sad, Faculty of Medicine, Sremska Kamenica, Serbia; 26PHI University Clinic of Pulmology and Allergy, Skopje, Macedonia; 27Pulmonary Diseases Unit, Azienda Ospedali Riuniti, Ancona, Italy; 28Institute for Pulmonary Diseases of Vojvodina, Clinical Trials Unit, Sremska Kamenica, Serbia; 29Maidstone Hospital, Maidstone, UK; 30Department of Pulmonary Medicine, Izmir D, Suat Seren Training and Research Hospital for Thoracic Medicine and Surgery, Izmir, Turkey; 31Service of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland; 32Department of Respiratory Medicine, Royal Preston Hospital, Preston, UK
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Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings.
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