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WHAT IS AMNIOTIC MEMBRANE?
Histologically, amnion (of which the amniotic membrane is a component) consists of multiple layers:
a single layer of cuboidal to columnar epithelium with microvilli, which is attached to
a basement membrane made up of collagen, and
an avascular, relatively sparsely populated cellular stroma that has three layers.
The last two layers (basement membrane and avascular stroma) form a protein matrix composed primarily of type III, IV and V collagen, along with some non-collagenous glycoproteins such as fibronectin, nidogen and laminin. This is the amniotic membrane.
HAS AMNION BEEN USED IN THE PAST?
Amnion has been used to treat human disease for more than 100 years with a growing list of applications:
Wound and burn management
Ocular tissue reconstruction
Spine surgery adhesion barrier
Reconstructive and plastic surgery
In many of these application, amnion has a favorable biologic properties and safety profile:
Supports natural endothelialization and the regeneration of healthy tissue
Anti-inflammatory property minimizes the foreign body response
Anti-microbial property reduces the risk of infection
Anti-fibrotic property minimizes obstructive granuloma formation
Anti-thrombotic property minimizes thrombus formation
IS THERE A NEED FOR NEW STENT TECHNOLOGY?
Complication/reintervention rates for current metallic tracheal stents range approximately 20-40%1-10
Breitenbücher A, et al. Long-term follow-up and survival after Ultraflex stent insertion in the management of complex malignant airway stenoses. Respiration. 2008;75(4):443-9. doi: 10.1159/000119053. Epub 2008 Mar 20.
Chhajed PN, et al. Therapeutic bronchoscopy for malignant airway stenoses: choice of modality and survival. J Cancer Res Ther. 2010 Apr-Jun;6(2):204-9. doi: 10.4103/0973-1482.65250.
Han X, et al. Individualized airway-covered stent implantation therapy for thoracogastric airway fistula after esophagectomy. Surg Endosc. 2017 Apr;31(4):1713-8. doi: 10.1007/s00464-016-5162-9. Epub 2016 Aug 12.
Lemaire A, et al. Outcomes of tracheobronchial stents in patients with malignant airway disease. Ann Thorac Surg. 2005 Aug;80(2):434-7; discussion 437-8.
Marchese R, et al. Fully covered self-expandable metal stent in tracheobronchial disorders: clinical experience. Respiration. 2015;89(1):49-56. doi: 10.1159/000368614. Epub 2015 Jan 15.
McGrath EE, et al. The insertion of self expanding metal stents with flexible bronchoscopy under sedation for malignant tracheobronchial stenosis: a single-center retrospective analysis. Arch Bronconeumol. 2012 Feb;48(2):43-8. doi: 10.1016/j.arbres.2011.09.008. Epub 2011 Dec 2.
Miyazawa T, et al. Implantation of ultraflex nitinol stents in malignant tracheobronchial stenosis. CHEST. 2000;69(2):398-401.
Nasir BS, et al. Palliation of Concomitant Tracheobronchial and Esophageal Disease Using a Combined Airway and Esophageal Approach. Ann Thorac Surg. 2016 Aug;102(2):400-6. doi: 10.1016/j.athoracsur.2016.03.021. Epub 2016 May 5.
Razi SS, et al. Timely airway stenting improves survival in patients with malignant central airway obstruction. Ann Thorac Surg. 2010 Oct;90(4):1088-93. doi: 10.1016/j.athoracsur.2010.06.093.
Saad CP, et al. Self-expandable metallic airway stents and flexible bronchoscopy: long-term outcomes analysis. Chest. 2003 Nov;124(5):1993-9.
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