A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs

Abstract

Background

Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome.

Objectives

Determine the overall prevalence of complications of tracheal stenting in dogs.

Methods

A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta-analyses were used to estimate pooled complications prevalence.

Results

Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%–100%, late: 75%; 95% CI: 63%–85%, and clinically relevant: 52%; 95% CI: 42%–61%), tracheobronchial infections (24%; 95% CI: 14%–35%), and granulomas (20%; 95% CI: 11%–30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%–20%), relapsing collapse (10%; 95% CI: 5%–15%), and stent migration (5%; 95% CI: 1%–9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough.

Conclusions and Clinical Importance

Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second-line procedure that does not necessarily alleviate the need for medical treatment and frequent follow-up visits. Additional studies are warranted to identify the risk factors of these complications.