Journal articles on the topic 'Stents (Surgery)'
To see the other types of publications on this topic, follow the link: Stents (Surgery).
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Stents (Surgery).'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Abreo, Kenneth, and Adrian Sequeira. "Role of stents in hemodialysis vascular access." Journal of Vascular Access 19, no. 4 (March 12, 2018): 341–45. http://dx.doi.org/10.1177/1129729818761280.
Full textAbstract:
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents. The latest randomized control trials reveal that stents decrease the number of interventions required to maintain patency but do not improve the overall access survival. Furthermore, bare metal stents have been shown to be inferior to stent grafts. This review discusses indications for stent deployment in the hemodialysis access, the current evidence for their use, and briefly touches on their complications.
2
Tang, Vincent CY, John Gillooly, Elaine WY Lee, and Clive R. Charig. "Ureteric Stent Card Register – A 5-Year Retrospective Analysis." Annals of The Royal College of Surgeons of England 90, no. 2 (March 2008): 156–59. http://dx.doi.org/10.1308/003588408x242123.
Full textAbstract:
INTRODUCTION Ureteric stenting is a common urological procedure. Forgotten stents have a well-documented morbidity and mortality. Therefore, we asked the question, is a stent register an important factor in reducing the number of lost or overdue stents? PATIENTS AND METHODS We conducted a retrospective review of 203 patients who had ureteric stents inserted in the operating theatre, for the 5-year period 1 December 1998 to 1 December 2003. We analysed all stent cards, patient notes and theatre logs; where no record of stent removal was found, we contacted the patient, their GP or their local hospital. RESULTS A total of 191 patients were identified from the stent card register. An additional 12 patients were found from the theatre logs, but with no record in the stent card register. Of the 203 patients, 8 had bilateral stents. The most common indication for stenting was stone disease. Of the 203 patients, 11 had overdue stents and 51 had no record of the stents ever being removed. The 51 presumed ‘forgotten’ stents were traced, and it was found that 42 patients had had their stents removed by other hospitals, and 9 patients died with stents in situ, but before they were due for removal. CONCLUSIONS Our current stent card tracking system is ineffective, because it was infrequently reviewed. However, despite overdue and ‘forgotten’ stents which were removed by other hospitals, no patients came to any real harm and we had no lost stents. Our stent register system did not appear to play any role in terms of preventing stent loss, and it seems likely that there are other more effective safeguards in place to prevent this from happening. However, if a stent register was required at all, a computerised system would be preferable. Alternatively, patients could share some of the responsibility of stent tracking with their clinicians.
3
Tammareddi, Sriram, and Qing Li. "Effects of Material on the Deployment of Coronary Stents." Advanced Materials Research 123-125 (August 2010): 315–18. http://dx.doi.org/10.4028/www.scientific.net/amr.123-125.315.
Full textAbstract:
Coronary stents have been more and more widely used in clinic over the past decade. There have been a large number of stents made of different biocompatible materials available commercially in the market. It is however unclear which is more suitable to specific patients. This raises a major concern whether the choice of stents could be assessed before a delivery surgery. This paper aims to provide a computational approach for evaluating the effect of stent materials on biomechanical outcomes of the deployments of stents in different patient. It will review the typical biomaterials being used for coronary stents, seeking to qualitatively assess them for use as coronary stents. Non-linear explicit finite element (FE) procedure is carried out using the Palmaz-Schatz stent geometry to quantitatively predict the effect of mechanical properties of these biomaterials on stent and coronary artery behavior during stent deployment. A quantitative comparison is made for exploring the effect of different materials on the deployment of stents. The study is considered significant in understanding the role how stent materials affect biomechanical responses to the coronary stenting. It provides a new methodology to promote a patient-specific assessment before surgery.
4
Canakcı, Cengiz, Erdinç Dinçer, Mehmet Burak Doğrusever, Mahmut Selman Mert, and Orkunt Özkaptan. "Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases." Endouroloji Bulteni 16, no. 2 (May 20, 2024): 58–63. http://dx.doi.org/10.54233/endourolbull-1442984.
Full textAbstract:
Objective: Double J (DJ) stents are widely used in urology practice. Forgotten ureteral stents can cause serious complications. We present our experience about forgotten ureteral stents with 49 cases. Material and Methods: The data of patients who were operated due to forgotten encrusted ureteral stents were examined retrospectively. Age, gender, side, presenting complaint, indwelling time, stent indication, surgery performed, complications, additional interventions and stone-free status were evaluated. For descriptive statistics, the mean, standard deviation, minimum and maximum frequencies and percentages were used. Results: Nineteen (38.8%) patients were female and 30 (61.2%) patients were male. The mean age of the patients was 47,06±14,11 (18-79). The mean indwelling time was 16.2±21,1 (3-120). Stents were placed in 30 patients due to stone surgery, 9 patients due to prophylactic before oncologic surgery, 8 patients due to hydronephrosis and two patients due to ureteral injury. For the treatment of the forgotten stent, ureteroscopy (including flexible ureterorenoscopy) was performed in 26 patients, endoscopic combined treatment in 11 patients, cystolithotripsy in 9 patients, open surgery in two patients and percutaneous nephrolithotomy in one patient. Conclusion: Removal of forgotten impacted ureteral stents can cause serious complications. The patients who were placed stents should be informed about the complications associated with forgotten encrusted stents.
5
Canakcı, Cengiz, Erdinç Dinçer, Mehmet Burak Doğrusever, Mahmut Selman Mert, and Orkunt Özkaptan. "Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases." Endouroloji Bulteni 16, no. 2 (May 20, 2024): 58–63. http://dx.doi.org/10.54233/10.54233/endourolbull-1442984.
Full textAbstract:
Objective: Double J (DJ) stents are widely used in urology practice. Forgotten ureteral stents can cause serious complications. We present our experience about forgotten ureteral stents with 49 cases. Material and Methods: The data of patients who were operated due to forgotten encrusted ureteral stents were examined retrospectively. Age, gender, side, presenting complaint, indwelling time, stent indication, surgery performed, complications, additional interventions and stone-free status were evaluated. For descriptive statistics, the mean, standard deviation, minimum and maximum frequencies and percentages were used. Results: Nineteen (38.8%) patients were female and 30 (61.2%) patients were male. The mean age of the patients was 47,06±14,11 (18-79). The mean indwelling time was 16.2±21,1 (3-120). Stents were placed in 30 patients due to stone surgery, 9 patients due to prophylactic before oncologic surgery, 8 patients due to hydronephrosis and two patients due to ureteral injury. For the treatment of the forgotten stent, ureteroscopy (including flexible ureterorenoscopy) was performed in 26 patients, endoscopic combined treatment in 11 patients, cystolithotripsy in 9 patients, open surgery in two patients and percutaneous nephrolithotomy in one patient. Conclusion: Removal of forgotten impacted ureteral stents can cause serious complications. The patients who were placed stents should be informed about the complications associated with forgotten encrusted stents.
6
Singer, Jordan L., Amir H. Aryaie, Mojtaba Fayezizadeh, Jon Lash, and Jeffrey M. Marks. "Predictive Factors for the Migration of Endoscopic Self-Expanding Metal Stents Placed in the Foregut." Surgical Innovation 24, no. 4 (April 6, 2017): 353–57. http://dx.doi.org/10.1177/1553350617702026.
Full textAbstract:
Background. With recent advancements in endoscopy, self-expandable metal stents (SEMS) have been used to treat gastrointestinal leaks, perforations, and strictures. Stent migration frequently complicates management and often requires additional treatments to reach resolution. Our study aimed to determine predictive factors for stent migration. Methods. Consecutive procedures involving SEMS placed with and without fixation after upper gastrointestinal surgery between 2009 and 2014 were retrospectively reviewed. Demographic, surgical history, rate of stent migration, and stent characteristic data were collected. Rates of stent migration were compared. Results. We reviewed 214 consecutive procedures involving stents placed in the foregut. Median duration of stent placement was 4.0 ± 10.3 weeks. Forty-three (20%) stents migrated after placement. Of those, 27 (63%) required stent replacement. Eleven (5%) procedures utilized stent fixation and 203 (95%) did not. Fixation techniques included endoscopic clips (9%), endoscopic sutures (73%), and transnasal sutures (18%). Stent migration rate was not different between those with and those without fixation ( P = .2). Rate of migration was significantly higher in procedures involving fully covered stents ( P < .001). Migration occurred after esophagectomy and gastric bypass ( P < .001 and P < .05, respectively) and in patients with diabetes ( P < .01). Conclusions. A challenge with SEMS use is stent migration. Diabetes and using fully covered stents were associated with migration as were SEMS used to treat complications of esophagectomy and gastric bypass. Stent fixation was not associated with the prevention of stent migration. No pattern was found that favors an approach to reduce stent migration.
7
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.
Full textAbstract:
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.
8
Caton, M. T., A. Z. Copelan, K. H. Narsinh, D. Murph, A. A. Abla, D. L. Cooke, S. W. Hetts, et al. "Form and Function in Intracranial Neurovascular Stents: A Historical Perspective and State-of-the-Art Clinical Review for the Noninterventionalist." Neurographics 11, no. 2 (March 1, 2021): 96–110. http://dx.doi.org/10.3174/ng.2000058.
Full textAbstract:
The use of intracranial stents in neurointerventional surgery has been practiced for decades. However, the spectrum of treatable pathology, available devices, and clinical adoption of intracranial stents has exploded in recent years. Diagnostic neuroradiologists play a critical role in the evaluation of these devices after deployment, yet may not be familiar with state-of-the-art intracranial stent devices and indications. This review provides an overview of intracranial stents for cerebrovascular disease, with 3 chief learning objectives: 1) to understand the basic principles of stent design, biomechanics, and deployment, and the resulting influence on cerebrovascular hemodynamics; 2) to be familiar with the spectrum of intracranial pathology amenable to endovascular stent placement; and 3) to recognize the radiographic appearance of successful intracranial stent deployment and intracranial stent‐related complications.Learning Objective: Recognize the key principles of design (form), current indications (function), and potential complications of intracranial stents used in neurointerventional surgery
9
Gumbienė, Lina, Sigitas Čibiras, Alicija Dranenkienė, Živilė Katliorienė, Giedrė Nogienė, and Eugenijus Kosinskas. "Aortos rekoarktacijos gydymas angioplastika ir stentais." Lietuvos chirurgija 5, no. 3 (January 1, 2007): 0. http://dx.doi.org/10.15388/lietchirur.2007.3.2225.
Full textAbstract:
Lina Gumbienė, Sigitas Čibiras, Alicija Dranenkienė, Živilė Katliorienė, Giedrė Nogienė, Eugenijus KosinskasVilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 VilniusEl paštas: Lina.Gumbiene@santa.lt Įvadas / tikslas Aprašomas naujo metodo – balioninės angioplastikos ir kraujagyslinių stentų – pritaikymas gydant aortos rekoarktaciją, atsiradusią po chirurginės ydos korekcijos. Ligoniai ir metodai Atlikta retrospektyvi duomenų analizė dešimties ligonių, kuriems Vilniaus universiteto Širdies chirurgijos centre 1994–2006 metais aortos rekoarktacija buvo gydyta balionine angioplastika ar stentavimu. Aprašoma centre taikyta aortos angioplastikos ir stentų implantavimo metodika. Rezultatai Aortos rekoarktacijos angioplastika atlikta keturiems ligoniams. Intraaortinis gradientas aortos koarktacijos vietoje po procedūros sumažėjo vidutiniškai 82,15%. Vėlyvuoju stebėjimo periodu (vid. 6,14 ± 5,2 metai) rekoarktacija buvo trims ligoniams. Aortos rekoarktacijos stentavimas atliktas septyniems ligoniams, vienam iš jų dėl atsinaujinusios rekoarktacijos po angioplastikos. Dviem ligoniams procedūra nepavyko. Kitiems penkiems ligoniams intraaortinis gradientas reAoCo vietoje vidutiniškai sumažėjo nuo 29,6 ± 11,6 mm Hg iki 2,6 ± 3,7 mm Hg. Stebėjimo laikotarpiu 0,58–3,75 metų po procedūros rekoarktacija nustatyta tik vienam ligoniui. Jam atliktas stento plėtimas. Išvada Perkateterinė balioninė angioplastika ir balionais išplečiami kraujagysliniai stentai veiksmingi ir saugūs aortos rekoarktacijų gydymo metodai. Pagrindiniai žodžiai: aortos koarktacija, rekoarktacija, perkateterinis gydymas Treatment of recurrent coarctation of the aorta employing balloon angioplasty and endovascular stents Lina Gumbienė, Sigitas Čibiras, Alicija Dranenkienė, Živilė Katliorienė, Giedrė Nogienė, Eugenijus KosinskasVilnius University, Centre of Heart Surgery, Santariškių g. 2, LT-08661 Vilnius, LithuaniaE-mail: Lina.Gumbiene@santa.lt Background / objective We present a new method of treatment – balloon angioplasty and endovascular stent – for patients with aortic re-coarctation following surgical correction. Patients and methods Ten patients with re-coarctation of the aorta after surgery underwent balloon angioplasty or stent implantation at Vilnius University Heart Surgery Centre in 1994–2006. Results Balloon angioplasty was performed in 4 patients. The intraaortic gradient in the site of coarctation decreased on average by 82.15% after the procedure. Re-coarctation developed in 3 patients in the late follow-up period (mean 6.14 ± 5.2 years). Stents were implanted in 7 patients (one developed re-coarctation after angioplasty). The procedure failed in two. The intraaortic gradient at the site of re-coarctation decreased on average from 29.6 ± 11.6 mm Hg to 2.6 ± 3.7 mm Hg. Re-coarctation was diagnosed only in one patient during the follow-up (0.58–3.75 years), and stent dilatation was performed in this case. Conclusions Balloon angioplasty and endovascular stents are effective and safe methods for the treatment of re-coarctation of the aorta. Key words: coarctation of the aorta, recurrent coarctation, transcatheter treatment
10
Yaniv, Dan, Lena Shlosberg, Joseph Flomenblit, Gregory Frenklach, Lea Rath-Wolfson, and Eitan Yaniv. "Removable Sinus Stent for Endoscopic Sinus Surgery: An Animal Trial." American Journal of Rhinology & Allergy 31, no. 1 (January 2017): e29-e32. http://dx.doi.org/10.2500/ajra.2017.31.4401.
Full textAbstract:
Background The goal of endoscopic sinus surgery in chronic sinusitis is to create good drainage of the paranasal sinuses. Metal stents used to prevent lateralization of the middle concha are associated with adverse effects. Objective The aim of this experimental study was to evaluate the feasibility and safety of a newly developed composite removable stent. Methods The composite removable stent was implanted in nine sheep (18 stents) in the ethmoid cavity after performing an ethmoidectomy and was examined for stability, ease of removal, and adverse effects. Histologic findings were compared between implantation and nonimplantation sites at several time points after stent deployment and removal. Results None of the stents migrated or fell out of the nose. After 4 weeks, there was no infection in the nose or around the stents, and there was no damage to the mucosa. An histologic study showed only mild-to-moderate inflammatory cell infiltration relative to control sites, with no damage to the mucosal epithelium and no necrosis at distant sites. At 2 weeks after stent removal, slight-to-moderate fibroplasia was noted in the deep nasal tissue, with slight-to-moderate osteocartilaginous metaplasia and bone remodeling but no necrotic or inflammatory changes in surrounding tissues. At 4 weeks after stent removal, the middle meatus remained open. Conclusion The promising results of the composite removable stent in a sheep model justify further studies in patients undergoing endoscopic sinus surgery for chromic sinusitis.
11
Sergeev, V. V., V. L. Medvedev, S. A. Gabriel, V. M. Durleshter, V. V. Churbakov, G. A. Palaguta, I. G. Aboyan, and A. K. Ismailov. "“Forgotten” Encrusted Ureteral Stents, Combined Endourological Approach." Innovative Medicine of Kuban, no. 1 (March 2, 2024): 78–85. http://dx.doi.org/10.35401/2541-9897-2024-9-1-78-85.
Full textAbstract:
Introduction: Ureteral stents have been widely used for drainage of the upper urinary tract during both emergency and elective surgical procedures since 1967. The main pathology in which these stents are used is urolithiasis.Objective: To present our experience with the surgical treatment of patients with “forgotten” encrusted ureteral stents using a combined endourological approach.Materials and methods: Patients with encrusted ureteral stents who underwent endourological procedures from 2016 to 2022 were prospectively evaluated. They were grouped based on the degree of stent encrustation according to the FECal classification. The duration of stent placement, number and types of surgical procedures, number of procedures before complete removal of the stent and concrements, surgery duration, hospital stay, complications, concrement analysis, and frequency of complete concrement removal per surgery were compared between the groups. The combined endourological procedure was performed with the patient placed in the Galdakao-modified supine Valdivia position. This position allows simultaneous antegrade and retrograde endourological access.Results: The study included 46 patients grouped according to the FECal classification. In 38 patients, stents were successfully removed in a single procedure. The mean operative time, concrement-free status, and complication rate were 90.2 ± 19.8 minutes, 78.3%, and 32.6%, respectively. Total encrustation volume was higher for grades IV and V (5.6 ± 1.8 and 7.6 ± 2 cm3) compared with all the other grades. Percutaneous nephrolithotripsy and cystolithotripsy were the most common procedures in grades IV and V. Lithotripsy was commonly used for ureteral stent encrustation, especially in the groups with grades I and III. The operative time was longer in groups IV-V compared with groups I and II because percutaneous nephrolithotripsy was more frequent in these cases. Retrograde intrarenal surgery was performed in 88% of the cases with the combined approach to check whether concrements were present in the renal calyces and pelvis. In 5 cases, a flexible ureterorenoscope was advanced antegradely through a percutaneous access to disintegrate the encrustation of the proximal part of the stent’s ureteral section. Complications occurred in 32.6% of the patients. Most complications (26%) were minor: fever, pain, or gross hematuria. One case required segmental renal artery embolization for bleeding, and antibiotic therapy associated with an attack of pyelonephritis was adjusted in 2 cases.Conclusions: The endoscopic combined approach in the Galdakao-modified supine Valdivia position is a safe and effective technique that allows removal of “forgotten” encrusted stents, in most cases, in a single procedure. The FECal classification seems to be useful for surgical planning and prognosis.
12
Parkinson, Richard J., Christopher P. Demers, Joseph G. Adel, Elad I. Levy, Eric Sauvageau, Ricardo A. Hanel, Ali Shaibani, et al. "Use of Heparin-coated Stents in Neurovascular Interventional Procedures: Preliminary Experience with 10 Patients." Neurosurgery 59, no. 4 (October 1, 2006): 812–21. http://dx.doi.org/10.1227/01.neu.0000232836.66310.46.
Full textAbstract:
Abstract OBJECTIVE: Currently, there is minimal published data on the use of heparin-coated stents in the neurovasculature; however, these stents have a proven clinical record in the treatment of coronary disease. This article details our experience with the safety and technical aspects of stent deployment in the first 10 patients who had heparin-coated stents placed in the intracranial and cervical vasculature and the preliminary follow-up in most cases. METHODS: We retrospectively reviewed the clinical history, intra- and periprocedural data, and imaging for the patients who received heparin-coated stents in the cervical and intracranial vasculature for cerebrovascular disease between October 2002 and October 2003. RESULTS: Thirteen heparin-coated stents were placed in 10 patients. Seven out of the 10 patients had heparin-coated stents placed in the posterior circulation; the remaining three patients had stents placed in the anterior circulation. Four patients had stents placed intracranially. There was no acute or subacute in-stent thrombosis and no procedure-related complications. Follow-up was performed on most patients, with no clinical symptoms attributable to restenosis in any patient. CONCLUSION: This small series suggests that heparin-coated stents are safe for use in the treatment of cervical and intracranial atherosclerotic disease. Longer-term follow-up is needed to study the heparin coating effect on in-stent restenosis rates and to assess the long-term durability and clinical efficacy of this stent. The use of drug-coated stents in the cerebrovascular circulation is an area that warrants further investigation.
13
Bell, Randy S., William O. Bank, Rocco A. Armonda, Alexander H. Vo, and Charles W. Kerber. "Can a Self-Expanding Aneurysm Stent Be Clipped? Emergency Proximal Control Options for the Vascular Neurosurgeon." Neurosurgery 68, no. 4 (April 1, 2011): 1056–62. http://dx.doi.org/10.1227/neu.0b013e31820d5396.
Full textAbstract:
Abstract BACKGROUND: If a self-expanding stent has been placed during endovascular treatment of an aneurysm and subsequently an open aneurysm surgery becomes necessary in the same or an adjacent area, is it possible and safe to obtain proximal control by placing a temporary clip on the artery at a point where it contains the stent? OBJECTIVE: To evaluate the effect of temporary clip application to 3 separate stent systems in an in vitro flow model with the stated hypothesis that clip application to these stents will result in permanent stent deformation. METHODS: This is an in vitro flow model study using an accepted synthetic blood vessel substitute. The Neuroform3 (Boston Scientific), Enterprise (Cordis/Codman), and Pipeline (ev3) stents were deployed within the flow model; temporary clips were applied; and angiographic measurements subsequently made. RESULTS: Two 4 × 30-mm Neuroform3 stents, two 4.5 × 28-mm Enterprise stents, and two 3.75 × 20-mm Pipeline stents were successfully deployed and clipped repeatedly (4 iterations). Two- and 3-dimensional angiograms were obtained. After repeated clip occlusion, the Neuroform3 and Enterprise stents returned to their original configuration and diameter. Clip application to both also resulted in immediate flow arrest. In contrast, initial clip application to the Pipeline stents did not result in flow arrest, but the second single clip application did. The Pipeline stents were also irreversibly deformed after the experimental protocol, with an average luminal diameter reduction of 26.85% (P < .05). CONCLUSION: The Neuroform3 and Enterprise stents responded favorably to temporary clip application, returning to their original diameter after clip removal and showing no sign of permanent structural modification. The Pipeline flow-diverting stent, however, was irreversibly deformed by clip application. These data indicate that temporary clip application to certain stents is possible. Further in vivo study is required.
14
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.
Full textAbstract:
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.
15
Williams, Kevin G., Anthony JR Blacker, and Priyadarshi Kumar. "Ureteric stents: The past, present and future." Journal of Clinical Urology 11, no. 4 (July 31, 2017): 280–84. http://dx.doi.org/10.1177/2051415817722934.
Full textAbstract:
Ureteric stents are fundamental to modern-day urological practice. This article aims to chronicle their development over the last century and the key individuals whose efforts have made their development possible. Early stents were ureteric catheters that were exteriorised outside the body and were associated with complications including migration, infection and encrustation. The use of polyethylene stents in humans was first reported by Tulloch in 1952. Polyethylene was thought to be a promising material due to its durability and water-repellent nature. It would, however, suffer the problems that would become associated with stents over the following decades mentioned above. The first silicone ureteric stents were developed in the 1960s by Zimskind and provided prolonged, efficient drainage but were complicated with stent migration. Collars, wings, flanges and barbs were developed to help prevent migration. Finney developed a double ‘pig-tail’ stent in the 1970s which helped to prevent both proximal and distal migration and the modern-day ureteric stent was born. Modern polymers have been developed such as polyurethane or styrene ethylene-butylene (C-flex®). Metal stents have also been used over the last three decades including the Wallstent™, Resonance® and Memokath™ stents. They have shown promising results particularly when long-term relief of ureteric obstruction is needed. Various strategies are available for removal including cystoscopically, stents with a metallic end that can be removed by using a catheter with a magnet at the proximal end, tethered stents that can be removed noninvasively either by the urologist, nurse or even by the patient and dissolvable stents which are in development.
16
Mansour, H. A. K. A. "Double J stent of frontal sinus outflow tract in revision frontal sinus surgery." Journal of Laryngology & Otology 127, no. 1 (December 7, 2012): 43–47. http://dx.doi.org/10.1017/s0022215112002745.
Full textAbstract:
AbstractObjective:Frontal sinus surgery continues to challenge even the most experienced endoscopic sinus surgeon. Revision frontal sinus surgery is even more challenging. The use of stents in frontal sinus surgery has long been described, as an attempt to decrease the incidence of synechiae and stenosis.Method:This study included five patients who had previously undergone functional endoscopic sinus surgery but suffered recurrence of frontal sinusitis. Two had bilateral disease. Double J stents were used after endoscopic frontal sinusotomy. The stents were left in place for six months.Results:Four of the 5 patients (6 out of 7 sinuses) had a patent frontal outflow tract after 10 to 36 months’ follow up.Conclusion:Double J stents can be used as frontal sinus stents. They are well tolerated by patients, easily applied, and self-retaining with no need for sutures. The length of the stent can be altered according to the patient's anatomy and pathology.
17
Levy, Elad I., Ricardo A. Hanel, Jay U. Howington, Balazs Nemes, Alan S. Boulos, Fermin O. Tio, Ann Marie Paciorek, et al. "Sirolimus-eluting stents in the canine cerebral vasculature: a prospective, randomized, blinded assessment of safety and vessel response." Journal of Neurosurgery 100, no. 4 (April 2004): 688–94. http://dx.doi.org/10.3171/jns.2004.100.4.0688.
Full textAbstract:
Object. Use of the sirolimus-eluting stent has led to a reduction of in-stent stenosis following treatment of coronary atherosclerosis, whereas treatment of intracranial atherosclerosis with bare-metal stents results in excessive restenosis rates of approximately 40%. Neurotoxicity effects and vessel injury are unknown in the cerebral vasculature. To assess the safety profile and vascular effects of sirolimus-coated stents, the authors conducted a prospective comparative study in which drug-eluting and bare-metal stents were implanted in the canine basilar artery (BA). Methods. Sixteen mongrel dogs were randomized (eight animals per group) to receive either bare-metal 1.5 × 8—mm (six-cell) stents or sirolimus-eluting stents of the same dimensions. Interventionists, histopathologists, and histopathology technicians who participated in the study were blinded to the stent characteristics. Stents were implanted in the canine BA. Serial peripheral blood samples were obtained during the 1st week after implantation to determine the time-dependent serum concentration of sirolimus. Follow-up angiographic studies were performed 30 days after stent implantation to assess the effects of stent placement on the BA and brainstem perforating vessels. Explantation of the stent and BA was performed immediately after angiography by using a pressurized formalin fixation procedure. Histological and computer-assisted morphometric analyses of specimens obtained in each animal were performed. Sirolimus could not be detected in peripheral blood samples obtained later than 24 hours posttreatment. On follow-up angiography, all perforating vessels observed on initial angiograms remained patent, and no evidence of parent vessel damage or pseudoaneurysm formation was observed. Explanted vessels and brainstem sections did not demonstrate evidence of histological neurotoxicity, such as gliosis or infarction. No significant differences were found in the time to endothelialization of bare-metal and sirolimus-coated stents. Smooth-muscle cell (SMC) proliferation, the putative agent for restenosis, was lower in animals receiving sirolimus-coated stents (p = 0.003). Additionally, intimal fibrin density was increased in the dogs treated with sirolimus-coated stents (p < 0.0001). Histological evidence of an inflammatory response demonstrated a trend toward a reduced response in the sirolimus group (mean 0.58) compared with the bare-metal group (mean 0.83, p = 0.33). Conclusions. No neurotoxic effects were observed in the intracranial vessel walls or brainstem tissue in which sirolimus-coated stents were implanted. Compared with bare-metal stents, the sirolimus-coated devices did not impair endothelialization and, furthermore, tended to reduce the proliferation of SMCs. These findings indicate that sirolimus-coated devices may inhibit in-stent stenosis. Further studies with longer-term follow up are required to assess the restenosis rates of sirolimus-coated stents implanted in the intracranial vasculature.
18
Sun, Xiao Ting, Qi Zhou, Fei Du, Ming Feng Wu, Shen Fei Tang, and Yan Long Bi. "A Novel Effective Y-Shaped Silicon Stent for Treating Canalicular Laceration." Advanced Materials Research 652-654 (January 2013): 449–53. http://dx.doi.org/10.4028/www.scientific.net/amr.652-654.449.
Full textAbstract:
Purpose: To introduce the novel effective Y-shaped silicon stent for treating canalicular laceration. Methods: Fifty-four canalicular laceration cases (54 eyes) underwent the lacrimal surgery using the novel Y-shaped silicon stents were collected, and the stents were removed 3 months after surgery. All cases were followed up for 12 months. The operability of stenting and removing the stent were assessed. The data we collected during each follow-up are: stent position and integrity, aesthetic results, the discomfort, the symptom of epiphora, the patency of lacrimal passage, complications, and patient’s satisfaction. Results: The stenting time was 14.3±5.8 min and the time of removing it was 1.8±0.5 min. Both of the operability of stenting and removing were accessed to be easy in more than 94.4% cases. All stents were in position and integrated. 51 cases (94.4%) had no problems on aesthetic results. Three patients (5.4%) complained about the discomfort. Two cases (3.7%) had the symptom of epiphora, which were obstructed after removing the stents. Fifty-two cases (96.3%) were with patent canaliculus and satisfied with the surgery and symptom improvement. Only 5 cases (9.3%) had complications. Conclusion: The novel Y-shaped silicon stent is an effective stent for treating canalicular laceration.
19
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.
Full textAbstract:
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.
20
Graham, Laura A., Thomas M. Maddox, Kamal M. F. Itani, and Mary T. Hawn. "Coronary Stents and Subsequent Surgery: Reported Provider Attitudes and Practice Patterns." American Surgeon 79, no. 5 (May 2013): 514–23. http://dx.doi.org/10.1177/000313481307900528.
Full textAbstract:
Management of antiplatelet therapy in patients with cardiac stents who need subsequent surgery is complex. Current guidelines recommend delaying elective surgery or, if surgery is emergent, proceeding without aspirin cessation. This study assessed provider knowledge, attitudes, and practices for patients with cardiac stents needing subsequent surgery. A national survey was administered to Veterans Administration surgeons, anesthesiologists, and cardiologists. Questions examined guideline awareness and agreement, perceptions of bleeding risk and stent thrombosis, practice patterns for antiplatelet therapy management, and experience with perioperative stent thrombosis. Chi-square tests and generalized estimating equations were used to examine differences in reported practices. Among 295 respondents, guideline awareness (92%) and agreement (93%) were high but higher among cardiologists and anesthesiologists than surgeons. Guideline agreement and personal experience with stent thrombosis were also associated with reported practice patterns. In adjusted models for early surgeries, cardiologists and anesthesiologists were more likely to report continuation of dual therapy as compared with surgeons regardless of stent type (drug-eluting P = 0.03; bare metal P < 0.01). Despite successful guideline adoption, significant variations in practice patterns by provider type were found. Understanding reasons behind the variation and outcomes of various antiplatelet management strategies are important steps in optimizing care of patients with coronary stents undergoing noncardiac surgery.
21
Ilie, Victor G., and Vlad I. Ilie. "Ureteric Stent Use - Part of the Solution and Part of the Problem." Current Urology 11, no. 3 (2017): 126–30. http://dx.doi.org/10.1159/000447206.
Full textAbstract:
Background: The aim of the study is to comprehensively report on a single tertiary referral center experience with the use of ureteric stents, assess complication burden and determine risk factors to further inform institutional practice. Materials and Methods: The retrospectively analyzed cohorts includes 529 patients treated over a 12 months period. Data regarding details of the index pathology, stent characteristics and complications were collected retrospectively. Results: Most stents (58.9%) were used in the context of stone surgery. Stent encrustation occurred in 14.5% of patients and sepsis in 4.3%. There was a statistically significant difference between the complications of the stents removed after 90 days and the rest of the cohort. Infectious complications were more frequent in diabetic patients and in patients with chronic renal impairment. At our institution, we managed to avoid forgotten stents and catastrophic complications. Conclusion: Stent complications are the complex outcome of interplay between the foreign body and the collecting system environment, influenced by the nature and timing of surgery. Longer stent dwelling times are associated with increased complications rates, especially in patients with significant comorbidities.
22
Orlova, Elena I., and Dmitriy V. Davydov. "Lacrimal stents in the lacrimal pathways’ surgery." Ophthalmology journal 10, no. 4 (December 15, 2017): 48–55. http://dx.doi.org/10.17816/ov10448-55.
Full textAbstract:
This review addresses various types of lacrimal implants, which are used in the surgery of lacrimal pathways. The authors describe modern and used in the past methods of lacrimal passage restoration recanalization techniques, and dacryocystorhinostomy procedures by external and endonasal approaches using stents of various shape, size and design, which often determine the outcome of surgery and the degree of its efficacy. Lacrimal implants are constantly modified and improved. Indications for intubation and the extubation terms are not yet clearly defined. Techniques for lacrimal drainage restoration, lacrimal stents’ use, most effective stent models, indications and contraindications, conduct of experimental studies - all that questions are still awaiting further investigation. (For citation: Orlova EI, Davydov DV. Lacrimal stents in the lacrimal pathways’ surgery. Ophthalmology Journal. 2017;10(4):48-55. doi: 10.17816/OV10448-55).
23
Bohle, Wolfram, Ioannis Louris, Andre Schaudt, Joerg Koeninger, and Wolfram G. Zoller. "Predictors for Treatment Failure of Self-Expandable Metal Stents for Anastomotic Leak after Gastro-Esophageal Resection." Journal of Gastrointestinal and Liver Diseases 29, no. 2 (June 3, 2020): 145–49. http://dx.doi.org/10.15403/jgld-463.
Full textAbstract:
Background and Aims: Self-expandable metal stents are used for the treatment of anastomotic leaks after gastro- esophageal surgery. Predictors for treatment failure and complications are unknown. In this observational retrospective study, we summarize our experience with self-expandable metal stents for the treatment of anastomotic leaks, in order to determine the predictors of treatment failure.
Methods: Between 2009 and 2015, 34 patients with anastomotic leak after curative resection of gastro- esophageal cancer were treated with self-expandable metal stents. Gender, histology, comorbidity, body mass index, neoadjuvant therapy, previous surgery, leak size, and stent diameter were analyzed for their predictive value according to treatment success and complication rate.
Results: Leak closure rate was 76%. Risk factors for treatment failure were neoadjuvant chemo-radiotherapy, squamous cell histology, and esophageal tumor location. Gender, comorbidity, body mass index, neoadjuvant chemotherapy, and previous surgery were not correlated with outcome. Mortality rate was 20%, most often due to uncontrolled leak. Severe stent-related complications occurred in 15% of patients, most of them following insertion of a large-sized stent.
Conclusion: Squamous cell histology, neoadjuvant chemo-radiotherapy, and esophageal tumor location are predictors for treatment failure. Severe stent-related complications seem to be preferentially associated with the use of large-sized stents.
24
Škrlová, Kateřina, Kateřina Malachová, Alexandra Muñoz-Bonilla, Dagmar Měřinská, Zuzana Rybková, Marta Fernández-García, and Daniela Plachá. "Biocompatible Polymer Materials with Antimicrobial Properties for Preparation of Stents." Nanomaterials 9, no. 11 (October 31, 2019): 1548. http://dx.doi.org/10.3390/nano9111548.
Full textAbstract:
Biodegradable polymers are promising materials for use in medical applications such as stents. Their properties are comparable to commercially available resistant metal and polymeric stents, which have several major problems, such as stent migration and stent clogging due to microbial biofilm. Consequently, conventional stents have to be removed operatively from the patient’s body, which presents a number of complications and can also endanger the patient’s life. Biodegradable stents disintegrate into basic substances that decompose in the human body, and no surgery is required. This review focuses on the specific use of stents in the human body, the problems of microbial biofilm, and possibilities of preventing microbial growth by modifying polymers with antimicrobial agents.
25
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.
Full textAbstract:
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.
26
Zhu, Haobo, Jun Wang, Yongji Deng, Liqu Huang, Xiaojiang Zhu, Jun Dong, Jintong Sha, et al. "Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience." Journal of International Medical Research 48, no. 4 (April 2020): 030006052091878. http://dx.doi.org/10.1177/0300060520918781.
Full textAbstract:
Objectives We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis. Methods A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty. Results The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%). Conclusions Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.
27
Philip, Thomas Cherukara, Noble Thomas, Yousif Al-Serkal, and Amit Kumar Dutta. "Endoscopic Plastic Pigtail Stents for Leak after Bariatric Surgery: Effective as Primary and Rescue Therapy." Gastroenterology, Hepatology and Endoscopy Practice 4, no. 3 (June 3, 2024): 110–12. http://dx.doi.org/10.4103/ghep.ghep_11_24.
Full textAbstract:
Bariatric procedures are increasingly being performed to manage obesity. Postoperative leak is one of the serious complications after bariatric surgery. The management of leaks includes surgery and endoscopic interventions. Endoscopic interventions are less invasive and have shown good efficacy in treating leaks. This includes placement of stents (plastic or metal) or closure of leak by stitching or clipping. Among these, internal drainage by placement of plastic stents is probably the least expensive intervention. In this case series, we show the effectiveness of plastic stents in the management of postbariatric surgery leak in three different scenarios – early postoperative leak, delayed postoperative leak, and prior failed metal stent for treatment of leak.
28
Mahajan, Ritesh, and T. M. Nagaraj. "A retrospective study analysis of success rate following endonasal dacryocystorhinostomy with stents." International Journal of Otorhinolaryngology and Head and Neck Surgery 5, no. 3 (April 26, 2019): 568. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20191620.
Full textAbstract:
<p class="abstract"><strong>Background:</strong> Endoscopic endonasal dacryocystorhinostomy (EN DCR) has now become a procedure of choice for nasolacrimal duct obstruction or in chronic dacryocystitis. Lots of debate is still going on regarding stent placement following surgery. The purpose of this study is to analyse the subjective and objective success following EN DCR with stents.</p><p class="abstract"><strong>Methods:</strong> In this single centre study, 30 patients underwent EN DCR surgery from May 2011 to March 2013, out of those 20 eligible patients with 26 nasolacrimal duct obstructions underwent EN DCR with stents, and they were included in the study. Success rates were determined with subjective assessment of the patient symptoms and objective evaluation by lacrimal syringing. </p><p class="abstract"><strong>Results:</strong> 80.7% patients underwent primary surgery and 19.2% patient’s revision surgery, overall success rates was 88.4% out of which 95.2% success rate for primary surgery and 60% success rates of revision surgery. 11.5% of patients complained of persistent symptoms and success rate of ENDCR with stents was observed in 95.2% of patients after primary surgery and in 60% of patient’s after revision surgery. Stent removal was done on 4-6 weeks (mean duration- 5 weeks) and patients follow up time was 6 months.</p><p class="abstract"><strong>Conclusions:</strong> Whether to stent or to not still remain a topic of debate in EN DCR surgery, however ENDCR with stents represents the procedure of choice for treating nasolacrimal duct obstructions.</p>
29
van den Berg, Eline H., Jilling F. Bergmann, Michiel Ledeboer, Rob A. J. M. van Dijk, Robbert J. I. Bosker, and Frank ter Borg. "Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study." Digestive Surgery 32, no. 4 (2015): 262–68. http://dx.doi.org/10.1159/000381290.
Full textAbstract:
Background: Preoperative placement of self-expanding metal stents is used in patients with obstructing colon carcinoma to prevent an emergency operation. The perceived benefits remain the subject of discussion. The data-evaluating function and complications of stents in relation to radiological position are limited. Methods: Patients receiving a preoperative stent between 2003 and 2013 were retrospectively analysed in this single-centre study. We analysed radiological deployment, eccentricity and angulation of the stent directly after placement. Endpoints were clinical success (resolution of ileus), complications needing non-elective surgery (blow-out, perforation, persistent ileus, dislocation) and other complications (bleeding, infiltrate). Associations were corrected for other potential influences. Results: Eighty-two patients were included. In 22 patients (26.8%), the stent was placed proximal to the splenic flexure. Clinical success was present in 85.4%. Twenty-two patients (26.8%) had a complication of which 16 (19.5%) underwent urgent surgery for insufficient functioning of the stent; there were two blow-outs (2.4%). A more symmetrically placed stent was associated with clinical success (p = 0.042), with large overlap between groups. However, no association was found with non-elective surgery or complications. Also, angulation and deployment were unassociated with these outcomes. Conclusions: We could not establish an association between symmetry, angulation or deployment of self-expandable colonic stents with clinical success and complications.
30
Mohammadian, Reza. "Bilateral Iliac Arteries Stent Compression Following Pelvic Surgery: A Case Report and Review of Literature." International Journal of Clinical Case Reports and Reviews 15, no. 03 (December 29, 2023): 01–05. http://dx.doi.org/10.31579/2690-4861/359.
Full textAbstract:
Extrinsic compression of iliac arteries stents has been reported from different causes, such as uterine fibroids and orthopedic surgery. Although extrinsic compression of stents in the iliac veins has been widely studied, stent compression in the iliac arteries is less common. Here we presented a case with bilateral common iliac arteries stent compression following pelvic surgery. A patient (65-year-old woman) presented with acute critical right limb ischemia. Computed tomography angiography (CTA) showed occlusion of the right common and external iliac artery, and severe stenosis in the left common iliac artery. In addition, there was evidence of a Brenner tumor originating from the left ovary. The patient underwent endovascular recanalization of the right iliac arteries and bilateral balloon-expandable stent deployment, and the ovarian tumor was removed after three weeks. The control CTA scan showed asymmetric bilateral iliac arteries stent compression more prominent on the right side, then self-expanding stents were implanted bilaterally. In Conclusion although iatrogenic compression of the stent in the iliac artery is rare despite scarcity, it is important to maintain a high index of suspicion in selected cases and choose the proper stent accordingly.
31
Sreedevi Sunkara, Manoj Kumar Katragadda, Pandu Ranga Kumari Motepalli, Harinath Reddy N, Suresh Babu Sayana, and Ramesh Kandimalla. "Complications and retrieval of forgotten biliary stents: A clinical insight." Asian Journal of Medical Sciences 15, no. 4 (April 1, 2024): 254–59. http://dx.doi.org/10.3126/ajms.v15i4.60963.
Full textAbstract:
Background: Endoscopic biliary stenting is a common procedure in gastroenterology that uses plastic stents for short-term bile drainage. Aims and Objectives: This study explores the occurrence and consequences of forgotten or retained biliary stents. Materials and Methods: Conducted at King George Hospital in Visakhapatnam over 8 months, the study includes 12 patients with forgotten biliary stents. Diagnostic confirmation used X-rays, abdominal ultrasound, and magnetic resonance cholangiopancreatography. Four patients faced complications such as fractured distal pigtails and blocked stents, making retrieval challenging through standard methods like endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy. Results: The study involved 12 patients (median age: 48 years), with choledocholithiasis being the main reason for stent placement in 10 cases (83.3%). On average, patients showed symptoms 31.3 months after stenting, mostly presenting with cholangitis (83.3%). Stent removal was successful in 8 cases (66.6%) using ERCP, while advanced procedures like cholangioscopy or surgery were needed in the rest. No mortality was reported. Conclusion: Conducted during the COVID-19 pandemic, this study reveals a rise in neglected plastic biliary stents. Cholangitis, often with common bile duct stones, was a common complication. Standard ERCP techniques were less effective in cases with complicated stents, requiring alternative approaches like cholangioscopy or surgery. The cases emphasize the urgency of timely stent retrieval and the need to improve management protocols to prevent complications.
32
Levy, Elad I., Alan S. Boulos, Ricardo A. Hanel, Fermin O. Tio, Ronald A. Alberico, Mary Duffy Fronckowiak, Balazs Nemes, Ann Marie Paciorek, Lee R. Guterman, and L. Nelson Hopkins. "In vivo model of intracranial stent implantation: a pilot study to examine the histological response of cerebral vessels after randomized implantation of heparin-coated and uncoated endoluminal stents in a blinded fashion." Journal of Neurosurgery 98, no. 3 (March 2003): 544–53. http://dx.doi.org/10.3171/jns.2003.98.3.0544.
Full textAbstract:
Object. No animal model currently exists for the examination of time-dependent histological changes occurring in intracranial vessels after endoluminal stent placement. The authors' goal was to develop a reproducible in vivo model of stent implantation in intracranial vessels in dogs that was capable of demonstrating stent-related vascular changes after the implantation of coated and uncoated devices. Methods. The authors implanted heparin-coated or uncoated stents in the basilar arteries (BAs) of 11 mongrel dogs. In a 12th animal, one coated stent was implanted in the BA and a second uncoated one was implanted in the distal anterior spinal artery. All the devices were oversized to induce intimal injury. Surviving animals were observed for 12 weeks, after which they underwent repeated angiography before planned death and removal of the brain. Histological studies and computer-assisted morphometric analyses were conducted on stent-treated and untreated sections of the BAs to assess the percentage of stenosis, neointimal proliferation, vessel injury, and inflammation. Perforating vessels partially covered by stent struts (“jailing”) were studied for evidence of stenosis or occlusion. The pathologist, interventionists, histopathologist, histopathology technicians, and radiologist were blinded to the stent type. Seven stents (three uncoated and four coated) were removed from the six animals that were observed during the follow-up period. The mean neointimal proliferation was 0.42 mm2 in the group treated with uncoated stents and 0.18 mm2 in the group treated with heparin-coated devices (p = 0.04). Neointimal thickness was significantly increased in the group with uncoated stents (p = 0.04). The mean percentage of occlusion was less (12%) in the group with heparin-coated stents, compared with 22% in the group with uncoated devices (p = 0.07). When comparing results between the heparin-coated and uncoated devices implanted in the five animals that received a single stent only, greater differences (indicating a benefit from heparin-coated stents) were observed in neointimal area (p = 0.009), neointima/media ratio (p = 0.001), neointimal thickness (p = 0.002), and percentage of occlusion (p = 0.009). All brainstem perforating vessels covered by stent struts remained patent. Conclusions. This in vivo intracranial stent model was developed to assess proliferative and inflammatory responses to endoluminal stent implantation in the cerebrovasculature. The results indicate that a lower percentage of occlusion occurs 12 weeks after implantation of heparin-coated compared with uncoated stents.
33
Cho, Won-Sang, Hyun Sook Hong, Hyun-Seung Kang, Jeong Eun Kim, Young Dae Cho, O.-Ki Kwon, Jae Seung Bang, et al. "Stability of Cerebral Aneurysms After Stent-Assisted Coil Embolization." Neurosurgery 77, no. 2 (April 2, 2015): 208–17. http://dx.doi.org/10.1227/neu.0000000000000759.
Full textAbstract:
Abstract BACKGROUND: The availability of stents has widened the indications of endovascular intervention for cerebral aneurysms. OBJECTIVE: To elucidate the effect of stents on radiologic outcomes and to analyze the risk factors for aneurysmal recanalization via propensity score matching. METHODS: From the 735 aneurysms treated with coil embolization with stents (n = 187) and without stents (n = 548) between 2009 and 2011, 157 propensity score-matched case pairs were selected. The recanalization rates and relevant risk factors were analyzed. The mean follow-up interval was 24.1 ± 11.3 months (range, 6-48 months) and 22.9 ± 11.4 months (range, 6-56 months) in the stent and nonstent groups, respectively (P = .388). RESULTS: The stent group demonstrated lower recanalization rates than the nonstent group during both the 6-month (1.9% vs 10.2%, P = .004) and the final follow-up periods (8.3% vs 18.5%, P = .005). The multivariate analysis identified the following significant factors for recanalization: the use of stents (hazard ratio, 0.40; 95% confidence interval, 0.21-0.76, P = .005), larger aneurysm size (hazard ratio, 1.21; 95% confidence interval, 1.11-1.31, P < .001), and initially incomplete occlusion (hazard ratio, 2.39; 95% confidence interval, 1.28-4.43, P = .006). The incidence of permanent neurological complication tended to be higher in the stent group than in the nonstent group (3.2% vs 0%, P = .063). CONCLUSION: In this propensity score-matched analysis, stent implantation reduced the overall recanalization of the coiled cerebral aneurysms. However, the use of stents should be carefully decided upon.
34
Park, Min S., David Fiorella, Michael F. Stiefel, Shervin R. Dashti, L. Fernando Gonzalez, Cameron G. McDougall, and Felipe C. Albuquerque. "Vertebral Artery Origin Stents Revisited." Neurosurgery 67, no. 1 (July 1, 2010): 41–48. http://dx.doi.org/10.1227/01.neu.0000370010.09419.23.
Full textAbstract:
Abstract BACKGROUND Vertebral origin angioplasty and stenting (VOAS) with bare metal stents is associated with a high rate of in-stent restenosis (ISR). OBJECTIVE We evaluated the rate of ISR after VOAS with drug-eluting stents. METHODS Twenty patients (15 men, 5 women; age range, 36–88 years; mean, 63.7 years) were treated for VOAS with a paclitaxel-eluting stent (Taxus Express2, Boston Scientific, Natick, Massachusetts). Stenosis at follow-up was quantified as insignificant (0%–24%), mild (25%–49%), moderate (50%–74%), and severe (75%–100%). ISR was defined using a binary criteria of > 50% stenosis at follow-up angiography. RESULTS All procedures were technically successful with no periprocedural complications. Follow-up angiography (range, 4–48 months; mean, 14.7 months) showed insignificant stenosis in 9 patients, mild in 6, moderate in 4, and severe in 1. In 1 patient with “moderate” stenosis, the stent migrated distally; therefore, the lesion restenosis was not within the stent. Thus, 4 of 19 patients (21%) exhibited binary moderate or severe ISR, and 5 of 20 showed restenosis at the lesion (25%). The patient with severe stenosis developed stent thrombosis > 3 years after VOAS. CONCLUSION VOAS with drug-eluting stents was associated with a low incidence of periprocedural complications. Although the rate of restenosis was half that seen with the use of bare metallic stents, 21% of patients still developed moderate or severe ISR. These patients may require ≥ 1 revascularization procedures. The risk of delayed stent thrombosis may necessitate lifelong dual antiplatelet medications.
35
Catalano, Peter J., and Eric J. Roffman. "Evaluation of Middle Meatal Stenting after Minimally Invasive Sinus Techniques (MIST)." Otolaryngology–Head and Neck Surgery 128, no. 6 (June 2003): 875–81. http://dx.doi.org/10.1016/s0194-59980300469-8.
Full textAbstract:
OBJECTIVES: In this study, we compared postoperative synechia rates and morbidity for different middle meatal (MM) stents after minimally invasive sinus techniques(MIST). STUDY DESIGN: In a prospective study, we included 100 patients with bilateral chronic sinusitis undergoing MIST at a tertiary care facility with a single surgeon. METHODS: For all patients, MeroGel stents were placed in the right MM, Gelfilm stents were placed in the left MM. Follow-up consisted of 3 postoperative visits between weeks 1 and 12 with endoscopic evaluation for synechia, granulation tissue, stent retention, nasal obstruction, headache, and infection. RESULTS: Synechia developed in 4 patients on the left and in none on the right ( P = 0.04). There were no significant side-specific differences regarding postoperative nasal congestion, headache, or sinusitis. Mean stent retention time was 7.9 days for MeroGel and 5.6 days for Gelfilm ( P = 0.0004). CONCLUSION: Compared with Gelfilm, Merogel MM stents produced less synechia; Merogel retains its position in the MM longer than Gelfilm; and the incidence of postoperative MM synechia can be reduced when absorbable MM stents are used in conjunction with MIST.
36
Luigiano, Carmelo, Milena Di Leo, Leonardo Henry Eusebi, Matteo Barabino, Enrico De Nicola, Marco Giovenzana, Enrico Opocher, et al. "Management of Leaks Following Laparoscopic Sleeve Gastrectomy Using Specifically Designed Large Covered Metal Stents." Reviews on Recent Clinical Trials 16, no. 3 (July 16, 2021): 303–8. http://dx.doi.org/10.2174/1574887116666210204142417.
Full textAbstract:
Background: Leaks are the major complication associated with laparoscopic sleeve gastrectomy. Objective: The study aimed to assess the efficacy and safety of specifically designed large covered metal stents for the management of post-laparoscopic sleeve gastrectomy leaks. Methods: Prospectively collected databases from three Italian Endoscopy Units were reviewed. The primary outcome of the study was to evaluate the clinical success of stents placement, defined as complete resolution of clinical and laboratory signs of sepsis with radiological evidence of leak closure. Secondary outcomes were stent-related adverse events and mortality. Results: Twenty-one patients (67% females, mean age 45 years) were included in the study and a total of 26 stents were placed. Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 85.5% of patients. Stent-related adverse events occurred in 9 patients (43%), with stent migration as the most frequent complication (33%). Adverse events were more frequently observed in patients who had undergone bariatric surgery prior to laparoscopic sleeve gastrectomy compared to patients without previous surgery (83% et al. 27%, p=0.018). Conclusions: The placement of specifically designed covered metal stents appears to be an effective and safe therapeutic approach for post-laparoscopic sleeve gastrectomy leaks. Stent migration can be a frequent complication.
37
Borowiec, Anna M., Charlie S. K. Wang, Elaine Yong, Calvin Law, Natalie Coburn, Rinku Sutradhar, Nancy Baxter, Lawrence Paszat, and Jill Tinmouth. "Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study." Canadian Journal of Gastroenterology and Hepatology 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/1945172.
Full textAbstract:
Self-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristics, poststent insertion health outcomes, and health care encounters were recorded. 225 patients were identified over the study period. Median age was 69 years, 2/3 were male, and 2/3 had metastatic disease. Stent use for CRC increased over the study period and gastroenterologists inserted most stents. The median survival after stent insertion was 199 (IQR, 69–834) days. 37% of patients required an additional procedure. Patients with metastatic disease were less likely to go on to surgery (HR 0.14, 95% CI 0.06–0.32,p<0.0001). There were 2.4/person-year emergency department visits (95% CI 2.2–2.7) and 2.3 hospital admissions/person-year (95% CI 2.1–2.5) following stent insertion. Most admissions were cancer or procedure related or for palliation. Factors associated with hospital admissions were presence of metastatic disease, lack of chemotherapy treatment, and stoma surgery. Overall the use of stents for CRC obstruction remains low. Stents are predominantly used for palliation with low rates of postinsertion health care encounters.
38
Ahsan Ahmad, Md. Zaid Imbisat, and Rakesh K Anand. "Our experience of forgotten double-J stents in a tertiary care center." Asian Journal of Medical Sciences 14, no. 11 (November 1, 2023): 293–97. http://dx.doi.org/10.3126/ajms.v14i11.56545.
Full textAbstract:
Background: Double-J (DJ) stents have become an essential tool in the field of urology. Forgotten DJ stents are associated with significant morbidity and mortality, if not intervened timely. Aims and Objectives: In this study, we report our experience of forgotten stents related complications, along with its management and steps taken by us in preventing stent-related morbidity. Materials and Methods: We retrospectively analyzed the records of patients presented to the Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna with forgotten or long-term retention of DJ stents from January 2021 to December 2022. All cases were reviewed for age, gender, symptoms, indication of stent insertion, duration of stent insertion, radiological images, and procedures performed for management. Results: The mean age of the patients was 49.23 years. The mean duration of the indwelling stent in situ was 16.61 months. Presenting complaint was flank pain, recurrent urinary tract infection, dysuria, hematuria, and irritative lower urinary tract symptoms. Common indications of indwelling stents were ureteroscopic lithotripsy, percutaneous nephrolithotomy, and Laparoscopic pyeloplasty. Cystoscopy, ureteroscopy, cystolithotripsy, percutaneous nephrolithotomy, and open surgery were done to extract the forgotten DJ stent. Conclusion: Forgotten DJ stents are a source of severe morbidity. Patients and relatives counseling before and after the procedure is necessary in reducing stent-related complications.
39
Han, Patrick P., Felipe C. Albuquerque, Francisco A. Ponce, Christopher I. Mackay, Joseph M. Zabramski, Robert F. Spetzler, and Cameron G. McDougall. "Percutaneous intracranial stent placement for aneurysms." Journal of Neurosurgery 99, no. 1 (July 2003): 23–30. http://dx.doi.org/10.3171/jns.2003.99.1.0023.
Full textAbstract:
Object. Intracranial stent placement combined with coil embolization is an emerging procedure for the treatment of intracranial aneurysms. The authors report their results using intracranial stents for the treatment of intracranial aneurysms. Methods. A prospectively maintained database was reviewed to identify all patients with intracranial aneurysms that were treated with intracranial stents. Ten lesions, including eight broad-based aneurysms and two dissecting aneurysms, were treated in 10 patients. Four lesions were located in the cavernous segment of the internal carotid artery, two at the vertebrobasilar junction, two at the basilar trunk, one at the basilar apex, and one in the intracranial vertebral artery. Attempts were made to place stents in 13 patients, but in three the stents could not be delivered. Altogether, intracranial stents were placed in 10 patients for 10 lesions. Results that were determined to be satisfactory angiographically were achieved in all 10 lesions. Two patients suffered permanent neurological deterioration related to stent placement. In two patients, the aneurysm recurred after stent-assisted coil embolization. In one case of recurrence a second attempt at coil embolization was successful, whereas in the second case of recurrence parent vessel occlusion was required and well tolerated. Conclusions. Intracranial stents can be a useful addition to coil embolization by providing mechanical, hemodynamic, and visual benefits in the treatment of complex, broad-based aneurysms.
40
Hlatky, Mark A., and Dena M. Bravata. "Stents or Surgery?" Circulation 118, no. 4 (July 22, 2008): 325–27. http://dx.doi.org/10.1161/circulationaha.108.788489.
Full text
41
Kato, Naoki, Ichiro Yuki, Toshihiro Ishibashi, Ayako Ikemura, Issei Kan, Kengo Nishimura, Tomonobu Kodama, et al. "Visualization of stent apposition after stent-assisted coiling of intracranial aneurysms using high resolution 3D fusion images acquired by C-arm CT." Journal of NeuroInterventional Surgery 12, no. 2 (August 12, 2019): 192–96. http://dx.doi.org/10.1136/neurintsurg-2019-014966.
Full textAbstract:
PurposeWe used an imaging technique based on 3-dimensional (3D) C-arm CT to assess the apposition of three types of stents after coiling of intracranial aneurysms.MethodsAll patients with intracranial aneurysms were considered who received stent-assisted coiling with Enterprise2, Neuroform EZ, or Neuroform Atlas stents confirmed by C-arm CT imaging at our institution between June 2015 and November 2017. A 3D digital subtraction angiography (DSA) scan for vessel imaging followed by a high-resolution cone beam CT (HR-CBCT) scan for coil and stent imaging was performed. The images were fused to obtain dual volume 3D fusion images. We investigated malapposition of the stent trunk (crescent sign) and of the stent edges (edge malapposition) and used the χ2 statistic to test for an association with stent types. Inter-rater agreement between two raters was estimated using Cohen’s kappa statistics.ResultsWe evaluated 75 consecutive cases. Enterprise2 stents were used in 22 cases, Neuroform EZ in 26, and Neuroform Atlas in 27 cases. By stent type, crescent sign was detected in 27% of Enterprise2, 8% of Neuroform EZ, and none of Neuroform Atlas stents (p=0.007), while edge malapposition was detected in 27% of Enterprise2, 58% of Neuroform EZ, and 30% of Neuroform Atlas stents (p=0.05). Excellent (κ=0.81) and good (κ=0.78) agreement between the raters was found for the detection of edge apposition and crescent sign, respectively.ConclusionStent malapposition was clearly visualized by dual volume 3D imaging. The Neuroform Atlas stents showed good apposition even in vessels with strong curvature.
42
Harada, Kei, Shogo Oshikata, and Masahito Kajihara. "Optical coherence tomography evaluation of tissue prolapse after carotid artery stenting using closed cell design stents for unstable plaque." Journal of NeuroInterventional Surgery 10, no. 3 (March 30, 2017): 229–34. http://dx.doi.org/10.1136/neurintsurg-2017-013004.
Full textAbstract:
Background and purposeDuring carotid artery stenting (CAS) with the use of closed cell design stents for unstable plaques, tissue prolapse between stent struts was evaluated by optical coherence tomography (OCT).Methods14 carotid stenosis lesions diagnosed as unstable plaques by MRI were evaluated by OCT imaging during CAS using closed cell stents. Cross sectional OCT images within the stented segment were evaluated at 1 mm intervals. The slice rate for the presence of tissue prolapse between the struts was calculated.ResultsNo intra-procedural complications occurred. After single stent placement, plaque prolapse was observed in all cases. Slices with any and >500 µm tissue prolapse were seen in 30% and 7.8% of cases, respectively. In 5 of 7 lesions with tissue prolapse >500 µm, additional stents were overlapped. In cases with overlapping stents, slices with any tissue prolapse were significantly decreased from 26% to 16% (p=0.008); in particular, the occurrence of tissue prolapse >500 µm was significantly decreased from 15% to 2.3% (p<0.001). In one case of >500 µm tissue prolapse without an overlapping stent, delayed embolization due to an in-stent thrombus occurred 9 months after the procedure.ConclusionsOCT during CAS using closed cell stent for unstable plaques frequently revealed tissue prolapse between struts. Placement of overlapping stents significantly reduced tissue prolapse, particularly tissue prolapse >500 µm. However, closed cell stents used for unstable plaques may not solve the problem of tissue prolapse.
43
Nunes, J., A. P. Piedade, C. B. Duarte, and M. T. Vieira. "In Vitro Behavior and Surface Morphology of Modified 316L Stainless Steel Stents." Microscopy and Microanalysis 14, S3 (September 2008): 35–36. http://dx.doi.org/10.1017/s1431927608089307.
Full textAbstract:
When compared with conventional bare metal stents, such as 316L stainless steel, the introduction of drug-eluting stents can promote reduction in the incidence of in-stent restenosis. However, the chemical discrepancy between the metallic stent and the polymeric material that acts as the reservoir for the drug is responsible for some problems during the cardiovascular surgery. Besides the research work aiming at the development of new bulk alloys for stent production, focus as been also directed to the surface modification of these devices. However, the use of functional graded coatings (FGC), i.e., coatings with a gradient of chemical composition between the substrate and the outmost layer, has never been reported in devices for cardiovascular surgery.
44
Glättli, Andreas, Steven C. Stain, Hans U. Baer, Walter Schweizer, Jürgen Triller, and Leslie H. Blumgart. "Unresectable Malignant Biliary Obstruction: Treatment by Self-Expandable Biliary Endoprostheses." HPB Surgery 6, no. 3 (January 1, 1993): 175–84. http://dx.doi.org/10.1155/1993/78590.
Full textAbstract:
The primary goal in the treatment of malignant obstruction is the relief of jaundice. Although operative biliary bypass is a reliable method of palliation, nonoperative palliation may be desirable in selected patients.We report our experience with forty-eight self expandable metallic biliary endoprostheses (Wallstent) percutaneously placed in 35 patients with irresectable malignant biliary obstruction. In twelve patients more than one stent was necessary to bridge the entire length of the biliary stenosis. The obstruction was due to primary tumors in 14 and to lymph node metastases in 12. In nine patients transanastomotic stents were placed after previous bilioenteric anastomosis because of malignant obstruction. Complications occurred in 11 patients (31.4%), and five patients died within 30 days of stent placement (14.3%). The mean stent patency to date of patients discharged is 6.1 months, and the mean survival 7.2 months. Follow up data is available for 29 patients, and excellent palliation was achieved for more than 75% of the survival time in 22 (76%). Seven patients have had documented stent occlusion requiring further intervention (24%).In this selected group of patients, the results of percutaneous self-expandable stents are encouraging. However, our data does not support the initial reports of self-expandable endoprostheses that suggest an improved result compared to conventional plastic stents. A randomized study using either expandable stents as compared to operative biliary enteric bypass is necessary.
45
Graf, Thomas, Gitanas Kancerevycius, Linas Jonušauskas, and Patric Eberle. "Rational Design of Microfluidic Glaucoma Stent." Micromachines 13, no. 6 (June 20, 2022): 978. http://dx.doi.org/10.3390/mi13060978.
Full textAbstract:
Glaucoma is a common, irreparable eye disease associated with high intraocular pressure. One treatment option is implantation of a stent to lower the intraocular pressure. A systematic approach to develop a microchannel stent meshwork that drains aqueous humor from the anterior chamber of the eye into the subconjunctival space is presented. The stent has a large number of outlets within its mesh structure that open into the subconjunctiva. The development approach includes a flow resistance model of the stent. Local adaption of the stent’s tubular dimensions allows for adjustment of the flow resistance. In this way, an evenly distributed outflow into the subconjunctiva is achieved. We anticipate that microblebs will form at the stent outlets. Their size is crucial for drainage and control of intraocular pressure. An analytical model for bleb drainage is developed based on the porous properties of the subconjunctival tissue. Both models—the stent flow resistance model and the bleb drainage model—are verified by numerical simulation. The models and numerical simulation are used to predict intraocular pressure after surgery. They allow for a systematic and personalized design of microchannel stents. Stents designed in this way can stabilize the intraocular pressure between an upper and lower limit.
46
Naidu, Sailendra, Sadeer Alzubaidi, Grace Knuttinen, Indravadan Patel, Andrew Fleck, John Sweeney, Bashar Aqel, et al. "Treatment of Hepatic Artery Stenosis in Liver Transplant Patients Using Drug-Eluting versus Bare-Metal Stents." Journal of Clinical Medicine 10, no. 3 (January 20, 2021): 380. http://dx.doi.org/10.3390/jcm10030380.
Full textAbstract:
Hepatic artery stenosis after liver transplant is often treated with endovascular stent placement. Our institution has adopted use of drug-eluting stents, particularly in small-caliber arteries. We aimed to compare patency rates of drug-eluting stents vs. traditional bare-metal stents. This was a single-institution, retrospective study of liver transplant hepatic artery stenosis treated with stents. Primary patency was defined as time from stent placement to resistive index on Doppler ultrasonography (<0.5), hepatic artery thrombosis, or any intervention including surgery. Fifty-two patients were treated with stents (31 men; mean age, 57 years): 15, drug-eluting stents; 37, bare-metal stents. Mean arterial diameters were 4.1 mm and 5.1 mm, respectively. Technical success was 100% (52/52). At 6 months, 1, 2, and 3 years, primary patency for drug-eluting stents was 80%, 71%, 71%, and 71%; bare-metal stents: 76%, 65%, 53%, and 46% (p = 0.41). Primary patency for small-caliber arteries (3.5–4.5 mm) with drug-eluting stents was 93%, 75%, 75%, and 75%; bare-metal stents: 60%, 60%, 50%, and 38% (p = 0.19). Overall survival was 100%, 100%, 94%, and 91%. Graft survival was 100%, 98%, 96%, and 90%. Stenting for hepatic artery stenosis was safe and effective. While not statistically significant, patency improved with drug-eluting stents compared with bare-metal stents, especially in arteries < 4.5 mm in diameter. Drug-eluting stents can be considered for liver transplant hepatic artery stenosis, particularly in small-caliber arteries.
47
Paul Ekka, Nishith M., and Arpana Singh. "An Unusual Case of Retained DJ Stent." International Journal of Medical and Dental Sciences 6, no. 2 (July 1, 2017): 1543. http://dx.doi.org/10.18311/ijmds/2017/18848.
Full textAbstract:
Double J stents are an integral part of urological practice today. Ureteral stenting is done as an adjunct to ureteral surgery and for managing ureteral obstruction. Every urological surgery doesn't require DJ stenting and their use must be strictly restricted to selected cases. Retension is a common complication of ureteral stents and is mostly due to encrustations on a forgotten DJ stent. Here we report a case of retained DJ stent which was placed during open nephrolithotomy. It was neither forgotten nor encrusted, but was embedded in the renal parenchyma. As per our knowledge this is the first case of its kind to be reported in medical literature.
48
Zalzal, George H. "Stenting for Pediatric Laryngotracheal Stenosis." Annals of Otology, Rhinology & Laryngology 101, no. 8 (August 1992): 651–55. http://dx.doi.org/10.1177/000348949210100804.
Full textAbstract:
The treatment of pediatric laryngotracheal stenosis using open surgery to expand the airway has become a widely accepted and effective method. Stents and cartilage grafts represent the main features of expansion laryngotracheal surgery, which is indicated after failure of endoscopic treatment and/or in the presence of severe stenosis. Stenting is needed in all situations with the exception of using a single cartilage graft in the anterior subglottic lumen. There are several options available for stenting. The most valuable and commonly used stents are the Aboulker stent and the Silastic sheet roll. In looking for the features of an ideal stent, I analyzed 51 procedures using the Aboulker stent on 48 patients. The purpose of this report is to discuss these features and relate them to the Aboulker stent.
49
Grieshaber, Philippe, Irina Oswald, Marc Albert, Wilko Reents, Michael Zacher, Peter Roth, Bernd Niemann, et al. "Risk of perioperative coronary stent stenosis or occlusion in patients with previous percutaneous coronary intervention undergoing coronary artery bypass grafting surgery." European Journal of Cardio-Thoracic Surgery 57, no. 6 (February 3, 2020): 1122–29. http://dx.doi.org/10.1093/ejcts/ezaa003.
Full textAbstract:
Abstract OBJECTIVES There is an ongoing discussion about how to treat coronary stents during bypass surgery: Should patent stents be left alone and the stented vessels be ungrafted, or should every stented coronary artery receive a bypass graft? This study aims to determine the relevance of perioperative stent stenosis or occlusion on postoperative outcomes up to 3 years postoperatively. METHODS Patients undergoing coronary artery bypass grafting surgery (CABG) (±concomitant procedures) with previous percutaneous coronary intervention from 4 centres were prospectively included in this observatory study between April 2015 and June 2017. A coronary angiography was conducted between the fifth and seventh postoperative days. The preoperative and postoperative angiograms were assessed in a core laboratory, assessing the patencies of coronary stents and bypass grafts. The core lab investigators were blinded to the patients’ characteristics and perioperative course. RESULTS A total of 107 patients were included in the study. In the postoperative coronary angiography, 265 bypass grafts and 189 coronary stents were examined angiographically. Ninety-seven percent of preoperatively patent stents remained patent. New coronary stent stenoses were observed in 5 patients (4.7%). All 5 patients were asymptomatic and managed conservatively. Bypass stenoses were observed in 12 patients (11%), of whom were managed conservatively, 4 underwent percutaneous coronary intervention and 1 underwent redo-CABG. Two years postoperatively, 97% of patients were alive. Patients with new stent stenosis tended to have a better survival compared with patients with bypass stenosis (100% vs 73%; P = 0.09) up to 3 years postoperatively. CONCLUSIONS Perioperative coronary stent stenosis occurs rarely. It is safe to leave a patently stented coronary vessel without bypass grafting.
50
Yamasaki, S., K. Hashimoto, Y. Kawano, M. Yoshimura, T. Yamamoto, and M. Hara. "Treatment of Vertebro-Basilar Dissecting Aneurysms Using Intravascular Stents." Interventional Neuroradiology 12, no. 1_suppl (January 2006): 137–44. http://dx.doi.org/10.1177/15910199060120s123.
Full textAbstract:
Endovascular surgery is an established primary therapeutic modality for dissecting aneurysms at vertebro-basilar arteries. Intravascular stents can be used to treat the dissecting aneurysms for which simple obliteration procedures cannot be used. In such cases, stent implantation alone or a combination of stents and coils need to be selected properly by taking into consideration the site and shape of dissections. In this report, three patterns of stent application are described and their method of selection is discussed.