Journal articles on the topic 'Metallic stents'
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Hanai, Takahiro, Takashi Kawahara, Hiroaki Ishida, Shinnosuke Kuroda, Toshitaka Miyai, Masato Yasui, Shuntaro Aoki, and Hiroji Uemura. "Bilateral Encrusted Metallic Stent Successfully Removed by Ureteroscopic Lithotripsy Using a Ho:YAG Laser in a Patient with Malignant Myeloma." Case Reports in Oncology 13, no. 3 (December 17, 2020): 1501–5. http://dx.doi.org/10.1159/000511601.
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Ureteral stent encrustation is sometimes encountered, especially in cases in which a ureteral stent has been forgotten. An 84-year-old female patient with malignant myeloma underwent metallic ureteral stent insertion to treat malignant ureteral obstruction. At the time of scheduled ureteral stent exchange, the stent was heavily encrusted and could not be removed on either side. We performed endoscopic lithotripsy to remove the encrusted ureteral stents. The bilaterally encrusted metallic ureteral stents were successfully removed using Ho:YAG laser lithotripsy after inserting another ureteral stent placement besides the encrusted metallic ureteral stents.
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Tsuboi, Tomofumi, Tamito Sasaki, Masahiro Serikawa, Yasutaka Ishii, Teruo Mouri, Akinori Shimizu, Keisuke Kurihara, et al. "Preoperative Biliary Drainage in Cases of Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgery." Gastroenterology Research and Practice 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/7968201.
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Objective. To elucidate the optimum preoperative biliary drainage method for patients with pancreatic cancer treated with neoadjuvant chemotherapy (NAC).Material and Methods. From January 2010 through December 2014, 20 patients with borderline resectable pancreatic cancer underwent preoperative biliary drainage and NAC with a plastic or metallic stent and received NAC at Hiroshima University Hospital. We retrospectively analyzed delayed NAC and complication rates due to biliary drainage, effect of stent type on perioperative factors, and hospitalization costs from diagnosis to surgery.Results. There were 11 cases of preoperative biliary drainage with plastic stents and nine metallic stents. The median age was 64.5 years; delayed NAC occurred in 9 cases with plastic stent and 1 case with metallic stent (p=0.01). The complication rates due to biliary drainage were 0% (0/9) with metallic stents and 72.7% (8/11) with plastic stents (p=0.01). Cumulative rates of complications determined with the Kaplan-Meier method on day 90 were 60% with plastic stents and 0% with metallic stents (log-rank test,p=0.012). There were no significant differences between group in perioperative factors or hospitalization costs from diagnosis to surgery.Conclusions. Metallic stent implantation may be effective for preoperative biliary drainage for pancreatic cancer treated with NAC.
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Brown, James A., Christopher L. Powell, and Kristopher R. Carlson. "Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?" Scientific World JOURNAL 10 (2010): 1566–73. http://dx.doi.org/10.1100/tsw.2010.162.
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Metallic ureteral stents promise to offer superior upper urinary tract drainage with extended exchange intervals and freedom from extrinsic compression in patients with advanced malignancy or other significant obstructing retroperitoneal or pelvic processes. Existing literature indicates a variable experience with these relatively new devices, with some investigators reporting excellent results and long problem-free intervals, and others reporting less enthusiastic outcomes. We report a retrospective review of a series of five sequential patients undergoing placement of Resonance® (Cook Medical, Bloomington, IN) metallic ureteral stents for extrinsic ureteral compression refractory to placement of traditional (polymer) ureteral stents. Of five patients reviewed, three (60%) required additional operative intervention for stent migration or malposition. Four patients (80%) died of their primary malignancy <12 months after metallic stent placement. Four (80%) of five patients had obstruction of their stents demonstrated with nuclear renography and/or other imaging, and three (60%) required removal and alternative means of urinary tract drainage within 4 months of placement due to obstruction, intractable pain, or migration. Four patients (80%) had urinary tract infections (UTIs) within 4 months of stent placement. No obstruction was seen due to extrinsic ureteral compression after stent placement. Metallic ureteral stents may have utility for patients with pathological processes causing extrinsic ureteral compression refractory to the use of traditional polymer ureteral stents. However, metallic ureteral stents are not immune to obstruction, migration, and associated discomfort. Stent obstruction appears to be increased in patients with postoperative UTI.
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Rasmussen, I. C., U. Dahlstrand, G. Sandblom, L. G. Eriksson, and R. Nyman. "Fractures of self-expanding metallic stents in periampullary malignant biliary obstruction." Acta Radiologica 50, no. 7 (September 2009): 730–37. http://dx.doi.org/10.1080/02841850903039763.
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Background: Self-expanding metallic stents are widely used for relieving biliary duct obstruction in patients with unresectable periampullary malignancies. However, only a few studies have assessed the occurrence of fractures in these stents. Purpose: To determine the prevalence and significance of stent fracture after placement of self-expanding metallic stents for periampullary malignant biliary obstruction. Material and Methods: Over a 5-year period, 48 patients underwent placement of self-expanding metallic stents for periampullary malignant biliary obstructions. Stents were introduced 2–6 weeks after a percutaneous transhepatic biliary decompression. The medical records and relevant images were reviewed for stent patency, stent fracture, type of stent, and stent-related complications. Results: Stent fracture was detected in four of the 48 patients (8%): in one patient at 1 month and in three patients between 10 and 21 months after stenting. All four fractures involved one type of nitinol stent used in 38 patients. In one of the patients, fracture was complicated by life-threatening gastrointestinal bleeding. The mean survival time for all patients was 251 days (standard deviation [SD]±275 days) and the mean overall patency time for all stents was 187 days (SD±205 days). Conclusion: Stent fracture occurs after placement of self-expanding nitinol stents for periampullary malignant biliary obstruction. The low reported incidence of this complication may be due to a lack of awareness of and difficulty in detecting stent fracture. Fracture should be considered as a possible contributing factor in recurrent biliary obstruction after self-expanding metallic stent insertion.
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Wang, Yanli, Pengfei Dong, Jingyao Ke, Xiang Shen, Zongming Li, Kewei Ren, Xinwei Han, and Linxia Gu. "Experimental evaluation of self-expandable metallic tracheobronchial stents." Nanotechnology Reviews 8, no. 1 (October 29, 2019): 136–42. http://dx.doi.org/10.1515/ntrev-2019-0013.
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Abstract The self-expandable metallic stents have been widely used in tracheobronchial obstruction or fistulation, including the J-shaped and Y-shaped stents, named after the shape of the branch-stem junction of the stent. However, there is scarce data on the mechanical performance of these tracheobronchial stents, which is essential for optimal stent implantation. In this work, eight self-expandable metallic tracheobronchial stents in three types (i.e., straight, J-shaped, and Y-shaped), with or without cover, were characterized. The compression resistance of the stems was investigated through both compression and indentation tests. The bending resistance of the branches in the J-shaped and Y-shaped stents was assessed through the bending test. Our results demonstrated that the covered stents exhibited a significantly higher compression resistance and bending resistance than the uncovered ones. The branches had a minimal impact on the compression resistance of the stem. The branch of the J-shaped stent showed a significantly lower bending resistance than the Y shaped one. This work provides a testing framework for the J-shaped and Y-shaped stents,which could shed some light on the optimal design of stent with branches.
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Cwikiel, W., H. Stridbeck, and U. Stenram. "Electrolytic Stents to Inhibit Tumor Growth." Acta Radiologica 34, no. 3 (May 1993): 258–62. http://dx.doi.org/10.1177/028418519303400311.
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Obstruction of metallic stents used in the management of malignant biliary strictures is common and in several cases due to tumor growth through the stent wall. In an experimental animal model in rats, a tumor was implanted subcutaneously adjacent to different metallic stents. Ingrowth of tumor through the wall of these stents was frequent. A stent generating direct electric current on the basis of electrolysis was developed and tested in vitro and in the experimental model. The study confirms that an “electrolytic” stent can inhibit ingrowth of tumor.
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Cwikiel, Wojciech, Krasnodar Ivancev, and Anders Lunderquist. "Metallic Stents." Radiologic Clinics of North America 28, no. 6 (November 1990): 1203–10. http://dx.doi.org/10.1016/s0033-8389(22)02661-6.
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Newton, Mark R., and James A. Brown. "Full-Length Metallic Double J Stents: A Review of Resonance® Stents." Clinical Medicine Insights: Urology 5 (January 2011): CMU.S6604. http://dx.doi.org/10.4137/cmu.s6604.
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Ureteral stricture, regardless of etiology, remains difficult to treat. Mainstays of therapy include polymeric double J stents and percutaneous nephrostomy tubes, each with respective complications. Multiple retrospective studies have now been published using the Resonance metallic double J stent, which is the focus of this review. A literature search was completed utilizing Pub Med. Key words included metallic stent, Resonance stents, and ureteral stricture. All identified papers were included. The stent is generally well tolerated, with infections, hematuria, and voiding symptoms requiring removal in 0% –14% of patients. Stents remained in place for mean of 4 to 9.4 months with the exception of a single study evaluating ureteroenteric strictures, where average duration was 21 days. In most studies a subset of patients kept the stent in situ for > 12 months, indicating that for some, the Resonance stent is a viable option, though predicting which patients will do well remains difficult.
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Shah, Jimil, and Surinder Singh Rana. "Newer Stents for Unresectable Malignant Distal Biliary Obstruction: Striving for Perfection!" Journal of Digestive Endoscopy 12, no. 01 (March 2021): 059–62. http://dx.doi.org/10.1055/s-0041-1728841.
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AbstractEndoscopic biliary stenting is one of the most commonly used palliative procedure in patients with unresectable malignant distal biliary obstruction. Biliary stenting can be performed with either plastic or metallic stents. Stent occlusion and migration are important limitations of currently available stents. Variety of newer stents with varying designs and stent materials like stents with antimigratory properties, antireflux stents, drug-eluting stents, radioactive stents, and bioabsorbable stents are being developed to overcome the limitations of currently available stents. In this article, we are discussing two articles on the newer stent designs (plastic and metal stents) for biliary drainage in patients with unresectable malignant distal biliary obstruction.
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Mladenovic, A., K. Davidovic, B. Markovic, P. Anojcic, M. Stojadinovic, and H. Maksimovic. "Stricture recanalisation of the distal urether with various endoprothesis." Acta chirurgica Iugoslavica 57, no. 2 (2010): 61–64. http://dx.doi.org/10.2298/aci1002061m.
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Introduction: Application of the metallic stents in the interventional uroradioligy is the result of continuous development of the new generation methods percutaneous nephrostomy (PCN), ballon catheter dilatation (BCD), methal and covered stent application. Application of metal stents in the renal canal system was attempted in order to eliminate BCD and PCN - related limitations as well as poor therapeutic results of these methods in a number of etiopathogenic groups of urinary stasis. Years - long application of interventional uroradiology methods, until the development of metallic stengts had shown the following therapeutics facts: PCN is incapable to resolve the cause of urinary obstruction. Permanent good therapeutic BCD results mostly depend on pathohistological aspect of the stricture, metallic stents are most frequently the last choice in therapeutics approch to urinary tract obstructions and their application is directly dependent on previous therapeutics results accomplished by PCN and BCD. In therapeutical sequences new generation of covered stents have important place as method of selection in patients of irreversible uroopstruction of distal ureter. Objective: The main goal of this study was to analyze therapeutics results, advanteges and shortages of insercion plastics and opened metallic endoprothesis, and to analyze results of covered methal applications on the contrary of using older interventional uroradiology methods. Method: Sixthytwo patients with distal urether strictures threated in the Deparment of interventional uroradiology Institute of Radiology Clinical centre of Serbia in Belgrade, participated in the study. Results were analyzed with Person's 2- test, Fisher test and Student T-test. Results: In our study we had highly significant differences in comparison with number of patients and type of stents during the time after recanalization was reached. Also it was highly significant differences according the type of used interventional uroradiology method that treated proliferation and the success of recanalization. Conclusion: Application of covered temporary uretheral stents have number advantages against using generation older permanent methal endoprothesis.
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Dahlqvist, Caroline, Sebahat Ocak, Maximilien Gourdin, Anne Sophie Dincq, Laurie Putz, and Jean-Paul d’Odémont. "Fully Covered Metallic Stents for the Treatment of Benign Airway Stenosis." Canadian Respiratory Journal 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/8085216.
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Introduction.We herein report our experience with new fully covered self-expanding metallic stents in the setting of inoperable recurrent benign tracheobronchial stenosis.Methods.Between May 2010 and July 2014, 21 Micro-Tech® FC-SEMS (Nanjing Co., Republic of Korea) were placed in our hospital in 16 patients for inoperable, recurrent (after dilatation), and symptomatic benign airway stenosis. Their medical files were retrospectively reviewed in December 2014, with focus on stent’s tolerance and durability data.Results.Twenty-one stents were inserted: 13 for posttransplant left main bronchus anastomotic stricture, seven for postintubation tracheal stenosis, and one for postlobectomy anastomotic stricture. Positioning was easy for all of them. Stents were in place for a mean duration of 282 days. The most common complications were granulation tissue development (35%), migration (30%), and sputum retention (15%). Fifty-five % of the stents (11/20) had to be removed because of various complications, without difficulty for all of them. None of the patients had life-threatening complications.Conclusion.Micro-Tech FC-SEMS were easy to position and to remove. While the rate of complications requiring stent removal was significant, no life-threatening complication occurred. Further studies are needed to better define their efficacy and safety in the treatment of benign airway disease.
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Nordin, Jamillah Amer, Ahmad Kafrawi Nasution, and Hendra Hermawan. "Can the Current Stent Manufacturing Process be Used for Making Metallic Biodegradable Stents." Advanced Materials Research 746 (August 2013): 416–21. http://dx.doi.org/10.4028/www.scientific.net/amr.746.416.
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Stents have been routinely used for the treatment of coronary artery occlusion since the last two decades. They are made of corrosion resistant alloys such as stainless steel 316L, titanium and cobalt-chromium alloys; in addition, their manufacturing process is well developed. Currently, corrodible metals have been proposed for making stents that can degrade after serving its function (biodegradable stents). This article discusses applicability of the current laser-cutting-based stent manufacturing process for making biodegradable stents: from materials production to stent fabrication until implantation. It covers some practical and technical points extracted from literatures and authors experiences with clinicians and industrialists to be considered in developing metallic biodegradable stents.
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Di Mitri, R., and F. Mocciaro. "Y-Shaped Bilateral Self-Expandable Metallic Stent Placement for Malignant Hilar Biliary Obstruction: Data from a Referral Center for Palliative Care." Scientific World Journal 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/151502.
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Background and Aim. Malignant hilar strictures are a clinical challenge because of the current therapeutic approach and the poor prognosis. In recent years, self-expandable metallic stents have proven more effective than plastic stents for palliation of malignant hilar strictures, with the bilateral stent-in-stent technique registering a high success rate. We report our experience with Y-shaped endoscopic self-expandable metallic stents placement for treatment of advanced malignant hilar strictures.Methods. From April 2009 to August 2012, we prospectively collected data on patients treated with Y-shaped SEMS placement for advanced malignant hilar carcinoma. Data on technical success, clinical success, and complications were collected.Results. Twenty patients (9 males) were treated (mean age 64.2 ± 15.3 years). The grade of malignant hilar strictures according to the Bismuth classification was II in 5 patients (25%), IIIa in 1 (5%), and IV in 14 (70%). The mean bilirubin level was 14.7 ± 4.9 mg/dL. Technical success was achieved in all patients, with a significant reduction in bilirubin levels (2.9 ± 1.7 mg/dL). One patient experienced cholangitis as early complication, while in 2 patients stent ingrowth was observed. No stents migration was recorded. There was no procedure-related mortality. At the end of the follow-up (7.1 ± 3.1 months), 13 of the 20 patients (65%) had died.Conclusions. Our experience confirms endoscopic bilateral self-expandable metallic stents placement with stent-in-stent technique (Y-shaped configuration) as a feasible, effective, and safe procedure for palliation of unresectable malignant hilar strictures.
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Bansal, Sandeep, Shruti Dhingra, Babita Ghai, and Ashok K. Gupta. "Metallic Stents for Proximal Tracheal Stenosis: Is It Worth the Risk?" Case Reports in Otolaryngology 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/450304.
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Objective. To demonstrate the risk associated with blocked proximal tracheal stents when a patient presents with acute respiratory distress, with blockage of stent and what is the best management we can offer without damage to the stent and its associated complications.Case Report. A 22-yr-old, male patient, presented in severe respiratory distress. He had history of corrosive poisoning for which he was tracheotomised. A stainless steel wire mesh stent was placed in the trachea, from the subglottis, to just above the carina. One month later, he presented with a critically compromised airway with severe respiratory distress. Emergency tracheostomy was done and the metallic stent had to be cut open, in order to provide an airway.Conclusion. Management of blocked proximal stents with patient in respiratory distress remains a challenge. Formation of granulation tissue is common and fibreoptic bronchoscopic assisted intubation may not always be possible. A regular follow up of all patients with stents is essential. Placement of stents within a few centimetres of cricotracheal junction should not be encouraged for long term indications.
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Mygind, T., and V. Hennild. "Expandable Metallic Endoprostheses for Biliary Obstruction." Acta Radiologica 34, no. 3 (May 1993): 252–57. http://dx.doi.org/10.1177/028418519303400310.
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Expandable metal stents (20 Gianturco Z-stents and 1 Strecker stent deployed through 8.5 F sheaths) were used with initial success for palliating bile duct obstruction in 10 patients, 8 with malignant and 2 with benign strictures. Short-term failure occurred in one patient after 2 weeks, one died of unrelated causes after 10 days, and one remained jaundiced due to fulminant liver metastases. In the remaining 7 patients the obstruction was markedly palliated, with normalization of the serum bilirubin. Four have died without recurrent bile duct obstruction after a mean of 5.9 months, the 2 with benign strictures are well after 4 and 7 months, and one patient is presently palliated with a plastic endoprosthesis following reocclusion after 4 months. Expandable stents were easier to insert than conventional percutaneous endoprostheses of plastic polymers, and had longer patency in several patients, but reocclusion by tumor growth remains a constant threat in malignant disease. Metallic stents may be the therapy of choice in recurrent benign strictures, although the definitive conclusion needs longer observation and larger materials.
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Mori, Hiroyoshi, Robert Kutys, Maria Romero, Renu Virmani, and Aloke V. Finn. "Metallic Coronary Stents." JACC: Cardiovascular Interventions 10, no. 11 (June 2017): 1175–77. http://dx.doi.org/10.1016/j.jcin.2017.03.014.
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Avasarala, Sameer K., Lutz Freitag, and Atul C. Mehta. "Metallic Endobronchial Stents." Chest 155, no. 6 (June 2019): 1246–59. http://dx.doi.org/10.1016/j.chest.2018.12.001.
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Munro, CE, GFW Stamp, AW Phillips, and SM Griffin. "A tale of three stents: aortic stenting prior to oesophagectomy after oesophageal stents." Annals of The Royal College of Surgeons of England 100, no. 4 (April 2018): e78-e80. http://dx.doi.org/10.1308/rcsann.2018.0009.
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The use of endoluminal stents to treat anastomotic leaks post oesophagogastric resection remains controversial. While some advocate stents to expedite recovery, others advise caution due to the risk of major morbidity and mortality. We describe a case of anastomotic leak following total gastrectomy for adenocarcinoma treated with a self-expanding metallic stent. Complications with the initial stent were treated with a further stent, which compromised the function of the oesophagus and eroded into the aorta, necessitating a colonic reconstruction and endovascular aortic stenting.
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Bi, Yonghua, Jindong Li, Gang Wu, Zepeng Yu, Xinwei Han, and Jianzhuang Ren. "A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina." Acta Radiologica 61, no. 5 (September 22, 2019): 613–19. http://dx.doi.org/10.1177/0284185119875631.
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Background Bifurcated self-expanding metallic stents have mainly been primarily used for the treatment of airway disease around the main carina, but few studies have reported the use of small bifurcated stents to treat malignant bronchial fistula or severe stenosis around the upper left carina. Purpose We aimed to determine the safety, feasibility, and efficacy of small metallic bifurcated stent placement in the upper left carina. Material and Methods Twenty-two patients with malignant bronchial disease were treated with small bifurcated stents. All bifurcated stents were custom-designed according to the measurement of CT measurements and placed under local anesthesia with fluoroscopic guidance. Clinical outcomes and CT imaging data were retrospectively analyzed. Results A total of 27 stents were used in 22 patients, with two stents removed immediately after placement due to stent insufficient dilation and failure of sealing fistula. Twenty patients underwent successful treatment, with a technical success of 90.9%. Thirteen complications were found in 9 (40.9%) patients. Five patients underwent successful stent removal due to failure of sealing fistula (n = 2) or because they were effectively cured (n = 3) during the follow-up period. Ten patients died of cancer, one patient died of chronic renal failure, and one died of myocardial infarction. The one-, three-, and five-year survival rates were 48.0%, 40.0%, and 32.0%, respectively. The median survival was 12.7 months. Conclusion Small bifurcated self-expanding metallic stents are a safe and effective treatment option for malignant bronchial fistula or severe stenosis around the upper left carina, but complications are relatively high. Further prospective studies are needed to evaluate alternative treatment options.
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Ferenț, Ioan, András Mester, Monica Chițu, Annabella Benedek, Mihaela Rațiu, Roxana Hodas, and Imre Benedek. "CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study." Journal of Interdisciplinary Medicine 3, no. 3 (September 1, 2018): 152–59. http://dx.doi.org/10.2478/jim-2018-0033.
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Abstract Background: Computed tomography angiography (CTA) presents important limits in in-stent restenosis (ISR) evaluation in case of metallic coronary stents, due to the artifacts determined by stent struts, which alter in-stent plaque analysis. In case of bioresorbable scaffolds, stent strut resorption allows accurate evaluation of the vessel wall. Aim of the study: This study aims to compare the feasibility of CTA as a follow-up imaging method for ISR diagnosis following elective PTCA procedures, between bioresorbable scaffolds and metallic coronary stents. Material and methods: We conducted a prospective, observational study on 73 patients with elective PTCA procedures in their medical history, in whom 113 stents were assessed via CTA in order to diagnose ISR. Based on stent type, the patients were divided into two groups: Group 1 – patients with bioresorbable vascular scaffolds (BVS) (n = 30); and Group 2 – patients with bare metal stents (BMS) (n = 43). Plaque analysis was possible only in the BVS group with a post-processing research-dedicated software, Syngo.via Frontier, which identified plaque morphology and virtual histology composition. Results: After CTA evaluation, the BVS group presented a significantly higher incidence of severe coronary artery disease (CAD) (Group 1 – 73% vs. Group 2 – 30%, p <0.0001). The proximal part of the right coronary artery (RCA) presented a significantly higher percentage of metallic stents (14% BMS vs. 2% BVS, p = 0.0029). The comparative analysis of CTA sensibility for the visual evaluation of ISR identified a significantly higher percentage of diagnostic CT evaluations in the BVS group (Group 1 – 94% vs. Group 2 – 76.19%, p = 0.0006). CTA evaluation provided the most accurate results for the 3.0 and 3.5 mm devices. Regarding CTA sensibility for ISR diagnosis, the BVS group presented the smallest incidence of non-diagnostic CT evaluations. Conclusions: CTA evaluation of bioresorbable scaffolds is superior to metallic stent assessment, the latter being influenced by numerous sources of error dependent mainly on the presence of the metal structure.
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Bognár, Eszter, György Ring, Hilda Zsanett Marton, János Dobránszky, and János Ginsztler. "Polyurethane Coating on Coronary Stents." Key Engineering Materials 345-346 (August 2007): 1269–72. http://dx.doi.org/10.4028/www.scientific.net/kem.345-346.1269.
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Stents are special metallic or polymer endoprostheses of meshed structure and tube shape. Their function is to prevent restenosis in the arteries. Stents can be coated or uncoated. In the expanded part of the artery the chance of restenosis is bigger even without a stent so it is practical to coat the stents. The aim of this work is to present the results of the coating experiments made on the coronary stents. Three types of commercially available polyurethanes were used for these experiments. The coatings were produced by a dipping method. Electro-polished and non-electro-polished metallic sheets and stents were used for these experiments. Contact angle measurements were done to examine the wetting properties of the three different polyurethane coatings. The quality and the changing of the coatings were examined by different methods (stereomicroscope, scanning electron microscope and energy dispersive spectrometry).
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Zhou, Chuanguo, Baojie Wei, Jianfeng Wang, Qiang Huang, Hui Li, and Kun Gao. "Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction." Gastroenterology Research and Practice 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/6527879.
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Background. Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective. To assess the clinical features of biliary stent fractures and evaluate associated factors. Methods. One hundred fifty-six consecutive patients who underwent biliary SEMS placement for MBO treatment at Beijing Chaoyang Hospital affiliated to Capital Medical University, in 2010–2015, were evaluated retrospectively. Demographics, clinical features, stent parameters and patency times, and survival times were collected. Across the ampulla of Vater, balloon dilatation, number of stents, stent patency time, and survival time were compared between the stent and nonstent fracture groups. Results. There were 168 biliary metallic stents inserted in 156 patients, including 144 and 12 patients with one and 2-3 stents, respectively. Pre- and/or postballoon dilation was performed in 107 patients. Stents across and above the duodenal papilla were used in 105 and 51 patients, respectively. Six cases (3.8%) with stent occlusion had stent fractures. Single- and multiple-stent fracture rates were 4/144 (2.8%) and 2/12 (16.7%), respectively. Fracture times after stent deployment were 126.8 ± 79.0 (median, 115.5) days. Stent patency times in the stent and nonstent fracture groups were 151.8 ± 67.8 (median, 160.5) days and 159.3 ± 73.6 (median, 165.5) days, respectively. Overall survival times in the stent and nonstent fracture groups were 399.7 ± 147.6 (median, 364.0) days and 283.7 ± 126.1 (median, 289.0) days, respectively. Conclusion. Stent fractures following MBO treatment constitute a relatively rare long-term complication. Though there were no factors found to be significantly associated with SEMSs fracture, a trend could be observed towards more fractures in multistent, transpapillary, and balloon dilation groups.
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LIM, C. S., J. YONG, and K. M. TOH. "MANUFACTURING AND NEAR-PHYSIOLOGICAL TESTING OF A BIODEGRADABLE METALLIC CORONARY STENT (BMCS)." Journal of Mechanics in Medicine and Biology 07, no. 01 (March 2007): 89–100. http://dx.doi.org/10.1142/s0219519407002169.
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Permanent metallic stents are frequently used in cardiovascular interventions, due to the many advantages metals possess in bulk and surface properties, design and chemistry, as well as their high modulus and ease of producing thin sections. However, the presence of foreign bodies in humans is associated with many long-term safety concerns; removal of the stent is therefore preferred through a second intervention after recovery. Based primarily on this consideration, biodegradable stents have been of significant interest in the past few years. This paper reports the manufacturing and near-physiological testing of a novel Biodegradable Metallic Coronary Stent (BMCS). To date, very limited literature is available on this aspect of research. Generally, magnesium is reactive and generally difficult to process. However, preliminary results demonstrate strong feasibility of fabricating low-profiled magnesium-based biodegradable coronary stents. Near-physiological tests based on a specially designed accelerated radial stent fatigue system were carried out. Results show that the biodegradable stents retained their arterial scaffolding functions for up to one year (simulated) before totally being resorbed into the biological fluid past its point of functionality. The results obtained so far show great promise for application.
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Fortin, Marc, Paul MacEachern, Christopher A. Hergott, Alex Chee, Elaine Dumoulin, and Alain Tremblay. "Self-Expandable Metallic Stents in Nonmalignant Large Airway Disease." Canadian Respiratory Journal 22, no. 4 (2015): 235–36. http://dx.doi.org/10.1155/2015/246509.
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Airway self-expandable metallic stents (SEMS) were initially studied in malignant airway obstruction; however, their use in benign airway diseases has become progressively more frequent. This may be explained by their ease of insertion compared with silicone stents, which require rigid bronchoscopy for insertion. While initial experience with SEMS in benign disease suggested efficacy and promising short-term safety profile, long-term follow-up revealed significant complication rates. In addition to a high complication rate, the management of these complications is made more difficult by the semipermanent nature of these devices. Reported complications include infection, granulation tissue formation, stent migration, stent fracture, airway perforation and fistula formation, as well as extension of the initial injury, potentially eliminating other therapeutic options such as surgical resection. Therefore, SEMS should only be used in nonmalignant large airway disease as a last resort for patients in whom other endoscopic methods, including silicone stents and dilations, as well as surgical options have failed or are technically not feasible.
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Sawada, S., Y. Fujiwara, S. Furui, Y. Tanabe, N. Tanigawa, M. Kobayashi, T. Iwamiya, N. Morioka, and Y. Ohta. "Treatment of Tuberculous Bronchial Stenosis with Expandable Metallic Stents." Acta Radiologica 34, no. 3 (May 1993): 263–65. http://dx.doi.org/10.1177/028418519303400312.
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Gianturco expandable metallic stents were placed in 5 patients with dyspnea on exercise due to tuberculous bronchial stenosis. The stents were placed after dilatation with a 10-mm diameter high pressure balloon catheter. In all 5 patients, obstructive changes disappeared following the procedure, and dyspnea on exercise improved markedly. No complications related to the procedure were encountered. At follow-up during a period of up to 38 months, 2 patients showed bronchial restenosis at 11 and 17 months, respectively, after stent placement. Restenosis by granulomatous tissue was successfully treated by laser ablation. One patient showed slight one-day hemoptysis 26 months after stent placement.
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Shomura, Y., N. Tanigawa, T. Tokuda, S. Kariya, H. Kojima, A. Komemushi, and S. Sawada. "Composite material stent comprising metallic wire and polylactic acid fibers, and its mechanical strength and retrievability." Acta Radiologica 50, no. 4 (May 2009): 355–59. http://dx.doi.org/10.1080/02841850902774600.
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Background: Although metallic stents are characterized by strong expanse of force, thin walls, and easy stent deployment, their removal from the body is usually difficult or impossible due to the difficulty of unraveling their mesh structure. A stent built of a composite material comprising a metallic wire and a polylactic acid (PLA) fiber, in which the metallic wire component could be unraveled after PLA fiber degradation in the body, should allow easy stent removal. Purpose: To evaluate the mechanical strength and retrievability of a composite material stent comprising a metallic wire and a PLA fiber. Material and Methods: We produced a composite material stent comprising a metallic wire and a biodegradable fiber (hybrid stent). As the metallic wire is not cross-linked with itself, but with the PLA fibers only, the hybrid stent can be easily unraveled after PLA fiber degradation. This stent was built with a 0.2-mm stainless-steel wire and a 0.23-mm PLA fiber knitted in the same textile as an Ultraflex stent. For comparison, an identical stent was built using PLA fiber only (PLA stent). The mechanical strength of these stents was tested by the radial expansive force response against circumferential shrinkage stress load. Change in radial force due to PLA fiber degradation was estimated by adding an artificial PLA degeneration process, by immersing each stent in a water bath at 80°C for 48 hours. Retrievability of the hybrid stent after PLA degeneration was examined by hooking and pulling out the residual stainless-steel wire from a silicon tube. Results: The hybrid stent exhibited a linear response in radial expansive force within the range of 15% diameter reduction. The PLA stent did not exhibit linear response at over 15% diameter reduction. Decrease of radial expansive force after PLA degradation was within 5% of the original force in the hybrid stent, but the PLA stent did not create effective radial expansive force. Hybrid stents, even after PLA degradation, exhibited a linear response in radial expansive force, within the range of 15% diameter reduction. The metallic component of the heat-processed hybrid stent was easily unraveled by pulling out the wire. Conclusion: The hybrid stent comprising a stainless-steel wire and a PLA fiber appears to provide effective radial expansive force and retrievability.
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Kim, Yehree, Woo Seok Kang, Jeon Min Kang, Dae Sung Ryu, Min Young Kwak, Ho-Young Song, Jung-Hoon Park, and Hong Ju Park. "Technical Feasibility and Histological Analysis of Balloon-Expandable Metallic Stent Placement in a Porcine Eustachian Tube." Applied Sciences 11, no. 4 (February 3, 2021): 1359. http://dx.doi.org/10.3390/app11041359.
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There is a clinical need to develop a stent to treat obstructive and refractory Eustachian tube dysfunction (ETD) after balloon Eustachian tuboplasty. An animal model for stent placement in the Eustachian tube (ET) is needed to develop optimal designs and materials, as stents for ETD have not been clinically applied. The purpose of this study was to evaluate the technical feasibility of stent placement and histological changes in a porcine ET model. Six ETs were evaluated in three pigs. Cobalt–chrome alloy stents with two different diameters were placed in the left and right ET of each animal (right, 3.5 mm; left, 2.5 mm). The outcomes were assessed by endoscopic and fluoroscopic imaging during the procedure, computed tomography after the procedure, and by histological examinations. Stent placement was technically successful in all specimens after metallic guiding sheaths were located in the nasopharyngeal end of the ET. The mean luminal diameters of the proximal, middle, and distal portions of the larger stents in the right ETs were 3.48 mm, 2.54 mm, and 2.15 mm, respectively. In the left ETs using smaller stents, these values were 2.49 mm, 1.73 mm, and 1.42 mm, respectively. The diameters of the inserted stents differed by stent location and the original diameter. Histological findings showed tissue hyperplasia with severe inflammatory cell infiltration at 4 weeks after stent placement. In conclusion, stent placement into the porcine ET was technically feasible, and stent-induced tissue hyperplasia was significantly evident. The luminal configuration of the placed ET stent changed according to its non-elastic nature and anatomical features of the porcine ET. Using this model, ET stents of various materials and designs with anti-inflammatory or anti-proliferative drugs can be optimized for future treatments of ET dysfunction.
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Cordero, Juan A., and Darroch W. O. Moores. "Self-Expanding Esophageal Metallic Stents in the Treatment of Esophageal Obstruction." American Surgeon 66, no. 10 (October 2000): 956–59. http://dx.doi.org/10.1177/000313480006601010.
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Esophageal obstruction from any cause is debilitating. In patients with malignant obstruction palliation to relieve pain and dysphagia is the primary goal. Conventional endoluminal prostheses allow variable palliation. Covered expandable metallic stents with an 18-mm lumen allow improved deglutition. From December 1994 through December 1998, 59 patients underwent placement of self-expanding silicone-covered esophageal stents for esophageal obstruction. There were 36 men and 23 women ranging in age from 41 to 94. All patients underwent esophageal dilation using a flexible gastroscope and Savary bougies. After dilation placement of the stent was performed under fluoroscopic control. Follow-up was complete in all patients. Technical success was achieved in all patients. There was one postoperative death (bronchopulmonary fistula), one migration of the stent requiring removal, and one recurrent obstruction. The remaining stents were well tolerated even in the cervical region (four patients). All patients returned to a diet of solid foods. We conclude that covered self-expanding esophageal metallic stents are technically simple and safe to insert and appear to provide durable excellent palliation of esophageal obstruction due to either benign or malignant conditions.
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Nakka, Keerthana, Sri D. Nagarajan, Balamayilsamy Sundaravadivel, Subramanian Shankaravel, and Christopher Vimalson. "An Overview of the Design, Development and Applications of Biodegradable Stents." Drug Delivery Letters 10, no. 1 (February 12, 2020): 2–13. http://dx.doi.org/10.2174/2210303109666190617165344.
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Background & Objectives: Stents have been effectively used in the treatment of vascular diseases and further explorations are going on in treating various strictures including tracheal, intestinal, nasal, urethra and esophageal. Stents serve as a support to walls of the lumen to prevent restenosis. Metal stents prevent in-stent restenosis but the corrosion of the metallic framework causes further complications. To overcome the shortcomings of metallic stents, metallic Drug-Eluting Stents (DES) have been designed where the drugs are chosen as an anti-restenosis agent in such a way that it prevents thrombosis, neointimal proliferation and possess immunosuppressive properties. Biodegradable stents are becoming ideal, provided they effectively spot the target stricture and have long-term stability to support the walls of the body conduit which in turn aids in eliminating the need for a second surgery. Polymeric materials can be used to enhance the mechanical strength and prolong the degradation time of biodegradable DES, thereby making it an ideal choice for stenting. Discussion: This review focus on the progress made in the design, manufacture, characterization studies and applications of stents over the past decade. Conclusion: We concluded that the use of stents is now an emerging technique for the treatment of GI strictures caused due to colorectal cancer, esophageal cancer, cholangiocarcinoma, Crohn’s disease etc. Though BDS have several advantages, advanced techniques are needed for fabrication and suitable modification in the design of the scaffold to enhance its clinical efficacy and to thereby develop an ideal endoprosthetic device.
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Chu, Kent Man, and Edward C. S. Lai. "EXPANDABLE METALLIC BILIARY STENTS." ANZ Journal of Surgery 64, no. 12 (December 1994): 836–39. http://dx.doi.org/10.1111/j.1445-2197.1994.tb04559.x.
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Goodwin, Scott C. "Textbook of Metallic Stents." Radiology 207, no. 1 (April 1998): 146. http://dx.doi.org/10.1148/radiology.207.1.146.
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Hanawa, Takao. "Materials for metallic stents." Journal of Artificial Organs 12, no. 2 (June 2009): 73–79. http://dx.doi.org/10.1007/s10047-008-0456-x.
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Azarbal, Farnaz, and Matthew J. Price. "Newer-generation Metallic Stents." Interventional Cardiology Clinics 8, no. 2 (April 2019): 95–109. http://dx.doi.org/10.1016/j.iccl.2018.11.001.
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Duvanskiy, V. A., A. S. Vodoleev, D. L. Kriazhev, and I. I. Yarotskov. "COMPARATIVE EVALUATION OF THE USE OF COATED AND UNCOATED SELF-EXPANDABLE METALLIC STENTS IN MALIGNANT COLORECTAL OBSTRUCTION." Grekov's Bulletin of Surgery 178, no. 6 (March 18, 2020): 41–46. http://dx.doi.org/10.24884/0042-4625-2019-178-6-41-46.
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THE OBJECTIVE was to compare the efficacy and rate of complications in patients of groups with uncovered and covered colorectal stents.METHODS AND MATERIALS. The study included 102 patients who were admitted for emergency with symptoms of malignant colon obstruction, who were randomly installed covered and uncovered SEMS from December 2012 to September 2017.RESULTS. Clinical success was achieved with uncovered stents in 98 % of cases and 96 % with covered stents (relative risk (RR) 1.02). 95 % confidence interval (CI) 0.954–1.092). The incidence of complications in the group of uncovered stents was 9.8 %, in the group of covered stents – 3.9 % (RR 0.938, CI 0.841–1.046); the frequency of recurrences of obstruction did not significantly different between groups. The median duration of cumulative stent patency was 181 days in the group of uncovered stents and 218 days in the group of covered stents (p=0.427), the difference was statistically insignificant.CONCLUSION. The use of double covered and double uncovered stents is equally effectively and safely for patients with malignant colorectal obstruction. The frequency of reobstructions did not exceed 4 % and did not differ in the groups of covered and uncovered stents. The choice of the type of stent should be determined individually depending on the clinical situation.
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Visconti, Thiago Arantes de Carvalho, Wanderley Marques Bernardo, Diogo Turiani Hourneaux Moura, Eduardo Turiani Hourneaux Moura, Caio Vinicius Tranquillini Gonçalves, Galileu Ferreira Farias, Hugo Gonçalo Guedes, et al. "Metallic vs plastic stents to treat biliary stricture after liver transplantation: a systematic review and meta-analysis based on randomized trials." Endoscopy International Open 06, no. 08 (August 2018): E914—E923. http://dx.doi.org/10.1055/a-0626-7048.
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Abstract Background and study aims The first-line approach to anastomotic biliary stricture after orthotopic liver transplantation (OLTX) involves endoscopic retrograde cholangiopancreatography (ERCP). The most widely used technique is placement of multiple plastic stents, but discussions are ongoing on the benefits of fully-covered self-expandable metallic stents (FCEMS) in this situation. This study aimed to compare results from use of plastic and metal stents to treat biliary stricture after transplantation. Patients and methods Searches were performed in the Medline, EMBASE, SciELO/LILACS, and Cochrane databases, and only randomized studies comparing the two techniques were included in the meta-analysis. Results Our study included four randomized clinical trials totaling 205 patients. No difference was observed between the stricture resolution rate (RD: 0.01; 95 %CI [−0.08 – 0.10]), stricture recurrence (RD: 0.13; 95 %CI [−0.03 – 0.28]), and adverse events (RD: −0.10; 95 %CI [−0.65 – 0.44]) between the plastic and metallic stent groups. The metallic stent group demonstrated benefits in relation to the number of ERCPs performed (MD: −1.86; 95 %CI [−3.12 to −0.6]), duration of treatment (MD: −105.07; 95 %CI [−202.38 to −7.76 days]), number of stents used (MD: −10.633; 95 %CI [−20.82 to −0.44]), and cost (average $ 8,288.50 versus $ 18,580.00, P < 0.001). Conclusions Rates of resolution and recurrence of stricture are similar, whereas the number of ERCPs performed, number of stents used, duration of treatment, and costs were lower in patients treated with FCEMS, which shows that this device is a valid option for initial treatment of post-OLTX biliary stricture.
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Touzin, Maryse, P. Chevallier, Stéphane Turgeon, Paula Horny, and D. Mantovani. "Evaluation of the Corrosion Protection of Ultra-Thin Plasma Fluorocarbon Film Deposited on 316L Stainless Steel for Long-Term Stable Stents." Materials Science Forum 638-642 (January 2010): 10–15. http://dx.doi.org/10.4028/www.scientific.net/msf.638-642.10.
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Commonly made of 316L stainless steel and nitinol, metallic intravascular stents are medical devices used to scaffold a biological lumen, most often diseased arteries. While stenting procedures reduce the risk of restenosis, they do not eliminate it completely. Furthermore, other common complications observed are thrombosis, inflammation and corrosion of the stents. The corrosion of the device is induced by blood flow which provokes a degradation of its mechanical properties and leads to a high risk of release of potentially toxic metallic compounds, such as nickel-based oxides and metal ions. To lower these clinical complication rates and to prevent the corrosion of the metallic stent structure, coated stents have been developed during the last decade. Indeed, the coating is expected to improve the surface biocompatibility and corrosion resistance without compromising the stainless steel mechanical properties required for the stent implantation. The Food and Drug Administration (FDA) has already provided guidance on a series of non-clinical test protocols, methods and reports to evaluate the safety and effectiveness of intravascular stents. Properties such as the stability, durability, and adhesion of a stent coating, prior and after deployment, must be clearly assessed to demonstrate its efficiency. This study wants to evaluate the effectiveness against general and local corrosion of an ultra-thin fluorocarbon film deposited by plasma on pre-treated stainless steel. Cyclic polarization tests were used to measure the coating capacity to protect the substrate from localized corrosion and Tafel plot corrosion measurements were used to evaluate the general corrosion behaviour of uncoated and coated, flat and deformed samples.
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Bolz, K. D., S. Hatlinghus, R. Wiseth, H. O. Myhre, and A. Gronningsæter. "Angiographic and Intravascular Ultrasonographic Findings after Endovascular Stent Implantation." Acta Radiologica 35, no. 6 (November 1994): 590–96. http://dx.doi.org/10.1177/028418519403500616.
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The study was an attempt to evaluate the benefit of intravascular ultrasound imaging (IVUS) as a supplement to follow-up angiography after endovascular stent implantation. A consecutive series of 15 patients underwent stent implantation in the peripheral or coronary arteries. Ten Palmaz stents, 3 Palmaz-Schatz stents and 2 Wallstents were used. After a period from 1 to 6 months (mean 3.2 months) follow-up angiography was performed. In 12 cases the angiography was combined with IVUS of the stent and the adjacent vessel segments. In one case IVUS failed due to the tortuous course of the vessel, in another case the stent was occluded, and in one case IVUS was considered too hazardous. In stents of diameter ≥5 mm, ultrasound (US) did not reveal more information concerning vessel and stent diameter, stent stenosis and intraluminal surface contact than angiography alone. Smaller stents were insufficiently visualized by conventional radiologic methods. In small stents only IVUS permitted an exact stent identification and differentiation between stent stenosis and stenosis of the native vessel. At US imaging artifacts, caused by the highly reflectant metallic stent struts, interfered with the native vessel wall and partly obscured its structural details.
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Madden, Brendan P., and Abhijat Sheth. "An approach to tracheostomy in a patient with an expandable metallic tracheal stent." Journal of Laryngology & Otology 119, no. 9 (September 2005): 731–32. http://dx.doi.org/10.1258/0022215054797871.
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With increasing use of expandable metallic stents to manage patients with a variety of endobronchial pathologies, some will have a subsequent need for tracheostomy insertion. We describe a successful technique to insert a tracheostomy using rigid and fibre-optic bronchoscopy in a patient who had an 8 cm expandable metallic tracheal stent deployed previously on account of tracheomalacia.
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Sun, Fan, Thierry Gloriant, Philippe Vermaut, Pascal Jacques, and Frédéric Prima. "Beta Titanium Alloys with Very High Ductility Induced by Complex Deformation Mechanisms: a New Material Perspective for Coronary Stent Applications." Solid State Phenomena 172-174 (June 2011): 129–34. http://dx.doi.org/10.4028/www.scientific.net/ssp.172-174.129.
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The increased use of metallic biomaterials in contact with blood e.g. for application as coronary stents is steadily resulting in the development of new biomaterials. Conventional bare-metal stents made by stainless steel were reported on adverse reactions against human body and are gradually replaced by coated stainless steel. The new generation of stent requires fundamental improvements at the materials point of view. Although titanium and classical Ti-alloys display superior biocompatibility compared to other metallic materials (stainless steels, Co-Cr), the major drawback of their relatively low ductility (typically 15%-25% of elongation) seriously limits their applications as cardiovascular stents, where large ductility is basically required during the stent deployment procedure and long-term service. In this paper, new titanium alloys with high ductility, a binary Ti-12Mo (wt%) and a ternary Ti-9Mo-6W (wt%) were designed by using a chemical formulation strategy based on the electronic design method called “the d-electron alloy design method”. Both alloys were synthesized and thermo-mechanically treated into beta-metastable state. In tensile tests, both alloys exhibited outstanding ductility of 43% and 46% in total elongation at room temperature, which is almost two times greater than the normal value shown with classical titanium alloys. Optical microscopy and detailed TEM observations on the deformed specimens revealed a complex deformation mechanism, involving {332}<113> mechanical twinning, stress induced plate shaped omega phase and stress induced martensitic (SIM) transformation β-α’’.
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Saeed, Saad Muhammad, Sundus Bilal, Muhammad Zeeshan Siddique, Muhammad Saqib, Shahana Shahid, Azhar Noor Ghumman, and Muhammed Aasim Yusuf. "Pyloric stent insertion in malignant gastric outlet obstruction: moving beyond palliation." Therapeutic Advances in Gastrointestinal Endoscopy 14 (January 2021): 263177452110470. http://dx.doi.org/10.1177/26317745211047012.
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Background: Self-expandable metallic stents have not only largely replaced surgical gastrojejunostomy for unresectable gastric cancers, but their role as bridging therapy for resectable obstructing tumours is also evolving. Objective: To evaluate the efficacy and safety of pyloric stents in gastric outlet obstruction in patients with gastric cancer and assess survival in patients with resectable obstructing gastric tumours in whom stents were inserted as a bridge to surgery. Methods: We retrospectively reviewed the electronic medical records of patients who underwent self-expandable metallic stent insertion for gastric outlet obstruction due to gastric cancer from January 2014 to March 2019. Results: Out of 161 patients, clinical improvement was observed in 159 (99%) and 156 (97%) at 1 and 12 weeks of stent placement, respectively. None of these patients experienced serious complications, such as perforation or aspiration pneumonia. Of these 161 patients, enteral stents were placed as bridging therapy prior to surgery in 40 (24.8%). Among these, 35 (87.5%) of 40 underwent neo-adjuvant chemotherapy followed by curative surgery. Of the 35 patients, 3 failed to follow-up. One-year survival following curative surgery was 87.5%. Stent helped to reduce vomiting and improve nutrition, measured by the body mass index ( p = 0.36) and serum albumin ( p = 0.05), over a 4-week period following stent insertion. Conclusion: Pyloric stents are useful in relieving malignant gastric outlet obstruction, maintaining nutrition during neo-adjuvant treatment and improving survival without additional risk of postoperative complications. They have traditionally been used for palliation, but should also be considered as bridging therapy for obstructing resectable gastric tumours during neo-adjuvant treatment.
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Lulich, Jody P. "Evaluation of Temporary Urethral Stents in the Management of Malignant and Nonmalignant Urethral Diseases in Dogs." Veterinary Sciences 9, no. 2 (February 1, 2022): 63. http://dx.doi.org/10.3390/vetsci9020063.
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Urethral stent placement is a minimally invasive interventional procedure commonly performed by specialists to alleviate urethral obstruction. However, the availability of urethral stents is limited by their high cost and the need for special equipment. The aim of this retrospective study was to describe the construction and placement of an inexpensive temporary urethral stent and to report on its outcome in managing dogs with naturally occurring urethral disease. Temporary stents were placed in the urethra of 17 dogs with malignant and nonmalignant urethral pathologies. The most common indication for temporary stent placement was urethral obstruction. In this population, urethral patency was restored in all dogs. The most frequently reported complication was urinary incontinence. To manage this complication, dogs were diapered. Temporary urethral stents served as a durable and inexpensive alternative to expanding metallic stents. Because temporary stents were constructed from readily available materials and inserted without special equipment, practitioners capable of catheterizing the urethra can insert them on demand.
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Andreev, A. V., V. M. Durleshter, A. I. Leveshko, S. A. Gabriel, and E. V. Tokarenko. "Antegrade biliary stenting for obstructive jaundice." Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery 24, no. 2 (June 24, 2019): 25–35. http://dx.doi.org/10.16931/1995-5464.2019225-35.
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Objective. To determine the role bile duct stenting with self-expandable metallic stents in the treatment of malignant obstructive jaundice. Material and methods. Eight-year experience of palliative antegrade stenting with self-expandable metallic stents was analyzed. There were 218 patients with malignant obstructive jaundice. Distal and proximal obstruction was diagnosed in 118 (54%) and 100 (46%) patients, respectively. We have used self-expandable metallic covered, partially covered and bare-metal stents with diameter of 10, 8 and 6 mm and length of 40, 60 and 80 mm. Results. Technical success in antegrade two-stage installation of self-expandable stents have been achieved in 208 (99%) patients. There were 230 deployed self-expandable metallic stents. Seven (3%) patients underwent simultaneous stenting of right and left hepatic ducts and confluence area with bare-metal stents. Stenting of right or left hepatic ducts and confluence area with partially covered stents was carried out in 34 (16%) patients. Other 59 (27%) patients with proximal biliary obstruction and no separation of lobar bile ducts underwent stenting with 27 partially covered and 31 covered stents. Distal obstruction was managed by using of covered stents as a rule (63%). Complications after antegrade biliary stenting occurred in 29 (13%) patients. Conclusion. Antegrade biliary stenting with metallic self-expandable stents is effective and minimally invasive approach. Moreover, it is comparable with conventional palliative interventions aimed at bile outflow recovery.
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Wang, Hongwu, Meimei Tao, Nan Zhang, Hang Zou, Dongmei Li, Hongming Ma, and Yunzhi Zhou. "Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing." Therapeutic Advances in Respiratory Disease 13 (January 2019): 175346661987152. http://dx.doi.org/10.1177/1753466619871523.
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Background: Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula. Methods: This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis. Results: A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis. Conclusions: Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.
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Tellambura, Mahima, Isaac Thangasamy, Kwang Chin, and Declan Murphy. "Effect of Metallic Ureteric Stents on Magnetic Resonance Imaging: Implications for Malignant Ureteral Obstruction." Société Internationale d’Urologie Journal 2, no. 4 (July 16, 2021): 256–58. http://dx.doi.org/10.48083/wlvr1509.
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Metallic ureteric stents are increasingly used for the management of malignant ureteric obstruction, a commonly encountered complication in urological and other malignancies. However, there has been limited evaluation of complications associated with these stents, including those that might arise from the use of magnetic resonance imaging (MRI). While most devices are deemed nominally “MRI-safe,” their implication on the quality of imaging produced has not been evaluated in clinical trials, and in our practice, significant artefact has been encountered with some ureteric stents—specifically, the Teleflex Rüsch DD tumour stent—compromising image quality and diagnostic certainty.
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Zakaluzny, Scott A., J. David Lane, and Eric A. Mair. "Complications of Tracheobronchial Airway Stents." Otolaryngology–Head and Neck Surgery 128, no. 4 (April 2003): 478–88. http://dx.doi.org/10.1016/s0194-59980300002-0.
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OBJECTIVE: Our goal was to identify and analyze airway stent complications and to devise approaches to manage stent complications. STUDY DESIGN AND SETTING: We conducted a retrospective review of patients from a tertiary medical center. METHODS: Twenty-eight airway stents were placed in 23 patients for benign (n = 15) and malignant (n = 13) tracheobronchial diseases. All patients were followed clinically for signs of complications. RESULTS: Nine complications (8 in those with benign disease and 1 in a patient with malignant disease) were identified and included stent migration (n = 3), excessive granulation tissue (n = 2), stent fracture (n = 1), poor patient tolerance (n = 2), and inability to place (n = 1). Avoidance and management strategies for stent complications are introduced. CONCLUSION: Tracheobronchial stents provide minimally invasive therapy for significant airway obstruction. Stent complications are more frequently encountered in the long-term treatment of benign conditions. Stents can be successfully removed endoscopically if complications arise, but the longer a metallic stent is in place, the more difficult it is to remove. SIGNIFICANCE: As airway stent use increases, proper management will be required to avoid and manage complications. This is the first report to focus on stent complications and their management.
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Pandelea-Dobrovicescu, George-Razvan, Mariana Prodana, Florentina Golgovici, Daniela Ionita, Maria Sajin, and Ioana Demetrescu. "Surface Morphology and Histopathological Aspects of Metallic Used Cardiovascular CoCr Stents." Metals 10, no. 9 (August 19, 2020): 1112. http://dx.doi.org/10.3390/met10091112.
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In this study, CoCr cardiovascular metallic stents with the same chemical composition as well as the adjacent tissues were analyzed. Recovered stents and adjacent tissues were characterized by surface morphology techniques like light microscopy (LM), scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM-EDS) and transmission electron microscopy (TEM). The presence of metals in the tissue from around explanted stent was also confirmed by TEM method. The released metal ions were measured using inductively coupled plasma mass spectrometry (ICP-MS). Histopathological analysis was used to highlight host tissue response to the implanted stents. EDX analysis revealed that 21 stents had the same composition. The quantities of Cr ions detected in the tissues were between 5 and 14 ppb and for Co ions were between 4 and 10 ppb. The tissue sections near the layers that generated large quantities of ions showed restenosis development and the deposits of surface calcifications were highlighted. The heavy metal levels observed in this study due to corrosion are too low to cause a systemic toxic response.
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Moyes, L. H., C. K. MacKay, and M. J. Forshaw. "The Use of Self-Expanding Plastic Stents in the Management of Oesophageal Leaks and Spontaneous Oesophageal Perforations." Diagnostic and Therapeutic Endoscopy 2011 (July 7, 2011): 1–6. http://dx.doi.org/10.1155/2011/418103.
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Leakage after oesophageal anastomosis or perforation remains a challenge for the surgeon. Traditional management has been operative repair or intensive conservative management. Both treatments are associated with prolonged hospitalisation and high morbidity and mortality rates. Self-expanding metallic stents have played an important role in the palliation of malignant oesophageal strictures and the treatment of tracheoesophageal fistulae. However, self-expanding metal stents in benign oesophageal disease are associated with complications such as bleeding, food bolus impaction, stent migration, and difficulty in retrieval. The Polyflex stent is the only commercially available self-expanding plastic stent which has been used in the management of malignant oesophageal strictures with good results. This review will consider the literature concerning the use of self-expanding plastic stents in the treatment of oesophageal anastomotic leakage and spontaneous perforations of the oesophagus.
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PANNEERSELVAM, NISANTHKUMAR, and SREEKUMAR MUTHUSWAMY. "DESIGN AND ANALYSIS OF NEW STENT PATTERNS FOR ENHANCED PERFORMANCE." Journal of Mechanics in Medicine and Biology 20, no. 06 (August 2020): 2050039. http://dx.doi.org/10.1142/s0219519420500396.
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Deploying a stent to restore blood flow in the coronary artery is very complicated, as its internal diameter is smaller than 3[Formula: see text]mm. It has already been proven that mechanical stresses induced on stent and artery during deployment make the placement of stent very difficult, besides the development of complications due to artery damage. Various stent designs have already been developed, especially in the metallic category. Still, there are possibilities for developing new stent designs and patterns to overcome the complexities of the existing models. Also, the technology of metallic stents can be carried forward towards the development of bioresorbable polymeric stents. In this work, three new stent cell designs (curvature, diamond, and oval) have been proposed to obtain better performance and life. The finite element method is utilized to explore the mechanical behavior of stent expansion and determine the biomechanical stresses imposed on the stent and artery during the stenting procedure. The results obtained have been compared with the available literature and found that the curvature cell design develops lower stresses and, hence, be suitable for better performance and life.
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Hausegger, K. A., J. Lammer, B. Hagen, F. Flückiger, M. Lafer, G. E. Klein, and E. Pilger. "Iliac Artery Stenting — Clinical Experience with the Palmaz Stent, Wallstent, and Strecker Stent." Acta Radiologica 33, no. 4 (July 1992): 292–96. http://dx.doi.org/10.1177/028418519203300402.
Full textAbstract:
A total of 82 iliac artery lesions (62 stenoses and 20 occlusions) were treated with 3 different types of endovascular metallic stents (12 lesions with the Palmaz stent, 36 with the Wallstent, and 34 with the Strecker stent). The complication rate was 12%. Occlusion of 2 Wallstents occurred 4 and 12 weeks after stent placement, respectively. Both stents were recanalized by local fibrinolysis. One Strecker stent occluded after 8 months. The observation period was 3 to 26 months (mean 9.7 months). The patency rate with secondary intervention (fibrinolysis) was 100% after 3 and 6 months, and 98% after 9 months. All 3 stent designs turned out to be effective in the treatment of complicated iliac artery occlusive disease.
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Henryk Matusiewicz and Magdalena Richter. "Local release of metal ions from endovascular metallic implants in the human biological specimens: An overview of in vivo clinical implications." World Journal of Advanced Research and Reviews 11, no. 1 (July 30, 2021): 091–102. http://dx.doi.org/10.30574/wjarr.2021.11.1.0326.
Full textAbstract:
Cardiovascular heart disease is one of the leading healthcare problems in this present era and need much care to prevent from this problem. The main reason for this problem is the accumulation of fats or plaque that blocks coronary arteries of heart which in turn resist the flow of blood to the heart walls and cause serious complications. The advancement in biomedical engineering and fabrication technology along with implantation technique made it possible and convenient to minimize the problems of coronary heart diseases. Small medical implantable metallic devices are used in contemporary cardio logical practice. Metals constitute the main components of these cardiovascular medical devices. A complication to the intervention and especially to bare metal stents is in-stent restenosis. Furthermore, limited information is available regarding the condition of stent surfaces and their interaction with vascular tissue following implantation. Corrosion of stents presents two main risks: release of metal ions into tissue and bodily fluids and deterioration of the mechanical properties of stents which may contribute to fracture. Release of metal ions could alter the local tissue environment leading to up-regulation of inflammatory mediators and promote in-stent restenosis. In this article we have reviewed studies that have characterized in vivo corrosion of cardiovascular metallic devices which is associated with release of metal ions into tissue and bodily fluids. This review further reports a possible association between stents and metal contact allergy. Potential clinical consequences of these observations are discussed.