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TracheobronchomalaciaNCT02982876

Airway Stents for Excessive Dynamic Airway Collapse

A study testing Dynamic Flexible Bronchoscopy, Rigid Bronchoscopy and Stent placement in people with Tracheobronchomalacia and Excessive Dynamic Airway Collapse, run by Beth Israel Deaconess Medical Center.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Airway stents are used as standard of care to identify which patients with excessive dynamic airway collapse will benefit from a definitive surgical treatment. However, the specific way in which these stents are effective has not been tested. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Dynamic Flexible Bronchoscopy, Rigid Bronchoscopy and Stent placement
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
No sites listed yet
Study dates
Dec 2016to 31 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient with sever symptomatic EDAC (collapse >90% of the airway during exhalation at dynamic CT scan)
  • Age > 18 years

Who cannot join

  • Patients who have not been well managed from their respiratory comorbidities (asthma, COPD, obstructed sleep apnea, GERD, relapsing polychondritis)
  • Current respiratory infection
  • Resting bradycardia (<50 beats/min), frequent multifocal PVCs, complex ventricular arrhythmia, sustained SVT
  • Dysrhythmia that might pose a risk during exercise or training
  • Any disease or condition that interferes with completion of initial or follow-up assessments

About this study

Official title: Airway Stents for Excessive Dynamic Airway Collapse: A Randomized Controlled Trial

Airway stents are used as standard of care to identify which patients with excessive dynamic airway collapse will benefit from a definitive surgical treatment. However, the specific way in which these stents are effective has not been tested. The purpose of this research study is to determine the effectiveness of airway stents when used in the airways of patients with severe symptomatic excessive dynamic airway collapse compared to patients with severe symptomatic excessive dynamic airway collapse that do not receive airway stent.

Read the detailed description

Study Design

This randomized controlled trial will be conducted at Beth Israel Deaconess Medical Center (BIDMC) in accordance with Good Clinical Practice Standards and under IRB supervision. We plan to enroll total of 48 patients with EDAC randomized by a computer generated system to either intervention group (airway stent) or medical management group.

Description of the study

Previous to appointment all patients will have Airway CT scan, 6 minute walk test and pulmonary function test as per protocol and standard of care.

Enrollment

Patients with severe EDAC who remain symptomatic despite optimal medical management will be informed about the trial and if interested will be recruited for the study.

Operative Technique

Patients in the treatment group (stent) will undergo bronchoscopy under light sedation and rigid bronchoscopy under general anesthesia. The treatment group will undergo a bronchial wash and placement of an airway stent.Patients assigned to the medical management group will not undergo bronchoscopy.

Stents

Based on the patient's airway anatomy an uncovered self-expanding metallic stent (Ultraflex™ Single-Use Tracheobronchial Stent System) or a silicone Y-stent(Endoxane, Novatech S.A., Aubagne-France or Channick Hood Laboratories, Pembroke, MA, 02359) will be used in the study.

During Stent Trial

After bronchoscopy, patients in the treatment group will receive a standardized medication regimen to include mucolytics, cough suppressors and expectorants in order to decrease the risk of potential complications following the procedure.

Follow-up

All participants will be scheduled for a follow-up visit in the following 14 days either after rigid bronchoscopy (treatment group) or after first visit (medical management group) with 6MWTs and PFTs. In this visit all patients will be asked to complete the SGRQ, CQLQ and mMRC questionnaires by the research team. All this data will be recorded in an encrypted database. Afterwards, the patients in the medical management arm will be offered a stent trial as part of standard of care.

Stent removal

The patients from the treatment arm will be scheduled for a rigid bronchoscopy, stent removal and bronchial lavage under anesthesia in the operating room.

Being tested
Dynamic Flexible Bronchoscopy, Rigid Bronchoscopy, Stent placement
Keywords
Silicone Airway stent, Metallic Airway stent
Medical subject headings
Tracheobronchomalacia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dynamic Flexible BronchoscopyProcedure or surgery

    The bronchoscope will be introduced into the proximal trachea at the level of the cricoid. At that point, patients will be instructed to take a deep breath, hold it and then blow it out (forced expiratory maneuver). Maneuvers will be done at the following six sites: proximal trachea at the level of the cricoid; mid-trachea 5 cm proximal to the carina; distal trachea 2 cm proximal to the carina; right main stem bronchus at the right tracheobronchial angle; bronchus intermedius and left main bronchus at the left tracheobronchial angle

  • Rigid BronchoscopyProcedure or surgery

    Under general anesthesia, a rigid bronchoscope (Bryan-Dumon Series II; Bryan Corporation; Woburn, MA) will be introduced, and respiration will be maintained through jet ventilation.

  • Stent placementDevice

    Silicone Y stent or uncovered self-expanding metallic stent will be placed in the standard fashion and good fit will be confirmed visually.

Study groups in NCT02982876
Study groupRoleWhat they receive
Medical Management GroupNo interventionThe patients assigned to the medical management group will be placed on a scheduled institution protocol using mucolytic and expectorant therapy (nebulizer treatments using mucolytic (N-acetylcysteine) for 15 minutes BID, Guafenesin (Mucinex®) 1200 mg BID, codeine as needed and Flutter valve BID.
Treatment groupActive comparatorThe patients assigned to treatment group will undergo flexible bronchoscopy with dynamic maneuvers, rigid bronchoscope , tracheobronchial wash and airway stent placement
Receives: Procedure: Dynamic Flexible Bronchoscopy; Procedure: Rigid Bronchoscopy; Device: Stent placement

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. St. George's Respiratory Questionnaire

    Index designed to measure health status in patients with respiratory symptoms

    Measured: 7-14 days

Secondary outcomes (7)
  1. modified Medical Research Council scale of dyspnea

    Shortness of breath scale

    Measured: 7-14 days

  2. Cough Quality of life Questionnaire

    Measured: 7-14 days

  3. 6 minute walk test

    Measured: 7-14 days

  4. FEV1

    Measured: 7-14 days

  5. Peak flow

    Measured: 7-14 days

  6. Self-reported symptoms

    dyspnea, inability to clear secretions, cough, recurrent infection and wheezing.

    Measured: 7-14 days

  7. Complications

    Airway infections

    Measured: 7-14 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Dec 2016 (estimated)
  2. Study startDec 2016
  3. Primary completion31 Dec 2024
  4. Study completion31 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02982876
Sponsor's protocol ID
2016P000246
Status last verified
May 2024
First submitted
2 Dec 2016
Last updated
28 Jul 2025
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Leong P, Bardin PG, Lau KK. What's in a name? Expiratory tracheal narrowing in adults explained. Clin Radiol. 2013 Dec;68(12):1268-75. doi: 10.1016/j.crad.2013.06.017. Epub 2013 Aug 13.

    PubMed 23953005
  • Murgu S, Colt H. Tracheobronchomalacia and excessive dynamic airway collapse. Clin Chest Med. 2013 Sep;34(3):527-55. doi: 10.1016/j.ccm.2013.05.003. Epub 2013 Jun 27.

    PubMed 23993822
  • Ridge CA, O'donnell CR, Lee EY, Majid A, Boiselle PM. Tracheobronchomalacia: current concepts and controversies. J Thorac Imaging. 2011 Nov;26(4):278-89. doi: 10.1097/RTI.0b013e3182203342.

    PubMed 22009081
  • Boiselle PM, O'Donnell CR, Bankier AA, Ernst A, Millet ME, Potemkin A, Loring SH. Tracheal collapsibility in healthy volunteers during forced expiration: assessment with multidetector CT. Radiology. 2009 Jul;252(1):255-62. doi: 10.1148/radiol.2521081958. Epub 2009 May 6.

    PubMed 19420322
  • Carden KA, Boiselle PM, Waltz DA, Ernst A. Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review. Chest. 2005 Mar;127(3):984-1005. doi: 10.1378/chest.127.3.984.

    PubMed 15764786
  • Jokinen K, Palva T, Nuutinen J. Chronic bronchitis. A bronchologic evaluation. ORL J Otorhinolaryngol Relat Spec. 1976;38(3):178-86. doi: 10.1159/000275273.

    PubMed 945891
  • Palombini BC, Villanova CA, Araujo E, Gastal OL, Alt DC, Stolz DP, Palombini CO. A pathogenic triad in chronic cough: asthma, postnasal drip syndrome, and gastroesophageal reflux disease. Chest. 1999 Aug;116(2):279-84. doi: 10.1378/chest.116.2.279.

    PubMed 10453852
  • Ikeda S, Hanawa T, Konishi T, Adachi M, Sawai S, Chiba W, Kosaba S, Hatakenaka R, Matsubara Y, Funatsu T. [Diagnosis, incidence, clinicopathology and surgical treatment of acquired tracheobronchomalacia]. Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jun;30(6):1028-35. Japanese.

    PubMed 1507676
  • Majid A, Gaurav K, Sanchez JM, Berger RL, Folch E, Fernandez-Bussy S, Ernst A, Gangadharan SP. Evaluation of tracheobronchomalacia by dynamic flexible bronchoscopy. A pilot study. Ann Am Thorac Soc. 2014 Jul;11(6):951-5. doi: 10.1513/AnnalsATS.201312-435BC.

    PubMed 24960030
  • Lee KS, Sun MRM, Ernst A, Feller-Kopman D, Majid A, Boiselle PM. Comparison of Dynamic Expiratory CT With Bronchoscopy for Diagnosing Airway Malacia: A Pilot Evaluation. Chest. 2007 Mar;131(3):758-764. doi: 10.1378/chest.06-2164.

    PubMed 17356090
  • Ernst A, Majid A, Feller-Kopman D, Guerrero J, Boiselle P, Loring SH, O'Donnell C, Decamp M, Herth FJ, Gangadharan S, Ashiku S. Airway stabilization with silicone stents for treating adult tracheobronchomalacia: a prospective observational study. Chest. 2007 Aug;132(2):609-16. doi: 10.1378/chest.06-2708.

    PubMed 17699133
  • Litmanovich D, O'Donnell CR, Bankier AA, Ernst A, Millett ME, Loring SH, Boiselle PM. Bronchial collapsibility at forced expiration in healthy volunteers: assessment with multidetector CT. Radiology. 2010 Nov;257(2):560-7. doi: 10.1148/radiol.10100219. Epub 2010 Sep 9.

    PubMed 20829540
  • Majid A, Sosa AF, Ernst A, Feller-Kopman D, Folch E, Singh AK, Gangadharan S. Pulmonary function and flow-volume loop patterns in patients with tracheobronchomalacia. Respir Care. 2013 Sep;58(9):1521-6. doi: 10.4187/respcare.02277. Epub 2013 Mar 12.

    PubMed 23481440
  • Tamura Y, Sakatani K, Yamakoshi N, Terada H, Honda H, Komori C, Kuhara H, Morishita N, Shishido K, Matsuoka H, Shishido N, Ishihara H. [A case of severe COPD associated with tracheo-bronchial stenosis, treated with non-invasive positive pressure ventilation]. Nihon Kokyuki Gakkai Zasshi. 2008 Nov;46(11):915-20. Japanese.

    PubMed 19068766
  • Ferguson GT, Benoist J. Nasal continuous positive airway pressure in the treatment of tracheobronchomalacia. Am Rev Respir Dis. 1993 Feb;147(2):457-61. doi: 10.1164/ajrccm/147.2.457.

    PubMed 8430971

Questions about this trial

What is this clinical trial studying?

A study testing Dynamic Flexible Bronchoscopy, Rigid Bronchoscopy and Stent placement in people with Tracheobronchomalacia and Excessive Dynamic Airway Collapse, run by Beth Israel Deaconess Medical Center.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

St. George's Respiratory Questionnaire (time frame: 7-14 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02982876, which also lists 36 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2025.

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