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Metallic Stents (metallic + stent)
Kinds of Metallic Stents Selected AbstractsEXPERIENCES OF SELF-EXPANDABLE METALLIC STENT FOR COLORECTAL OBSTRUCTIONS: 70 CASESDIGESTIVE ENDOSCOPY, Issue 2004Yoshihisa Saida ABSTRACT Clinical utilization of self-expandable metallic stent (EMS) endoprosthesis has come later for colorectal diseases than for other lesions. Recently, EMS has been used for palliative insertions for strictures caused by malignant diseases or as a ,bridge to surgery' for obstructive colorectal cancers, with good clinical results increasingly reported in many western countries. Its application for benign strictures has been reported, but we believe that the surgical indications require more careful analysis because of the absence of data concerning long-term prognosis. The advantage of this technique in the treatment of colorectal strictures is that it limits invasiveness, such as in palliative or temporary stoma creation, thereby improving patient quality-of-life. Therefore, we believe that EMS endoprosthesis will play a key role in this field. We are awaiting the introduction of the metallic stent for the colon and the associated kit, as well as the Japanese government's approval for reimbursement for this procedure. [source] SUCCESSFUL PLACEMENT OF SELF-EXPANDABLE METALLIC STENTS FOR DOUBLE COLORECTAL CANCERSDIGESTIVE ENDOSCOPY, Issue 4 2006Tsuyoshi Abe Stent placement for the palliation of unresectable colon cancer is an alternative to surgical treatment that has recently become popular. A dedicated stent for colorectal cancer is not available in Japan. We report a patient with two colonic obstructions who underwent a successful palliative treatment using two stents. He was admitted to Toho University Ohashi Medical Center because of ileus. A colonoscopy revealed two advanced lesions with stenosis in the sigmoid and transverse colon. Because he had multiple liver metastases and severe Alzheimer dementia, we selected palliative stent placement for the treatment of both strictures. We placed a covered stent in the sigmoid colon stricture and subsequently attempted to place a second stent in the transverse colon stricture. However, the second stent could not be placed in the transverse colon because the modified delivery system could not pass through the first stent in the sigmoid colon. This probably led to a twisting of the stent in the sigmoid colon. We next used the 24 F introducer sheath that is included in Keller-Timmermans Introducer Sets. This strategy allowed the modified delivery system to be easily passed through the initial stent in the sigmoid colon and then advanced into the transverse colon stricture, enabling both stents to be positioned properly. [source] Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of VaterDIGESTIVE ENDOSCOPY, Issue 4 2000Hitoshi Sano We have reported successful implantation of self-expandable metallic stents for palliative treatment in a case of an 87-year-old female patient with carcinoma of the papilla of Vater. She suffered from both duodenal and biliary stenoses, but refused surgical treatment. For the duodenal stenting, a self-expandable knitted nitinol metallic stent, for esophageal use, was inserted endoscopically. For the biliary stenting, a self-expandable metallic stent, partially polyurethane-covered on the proximal part to prevent tumor ingrowth and overgrowth, was inserted via the percutaneous transhepatic biliary drainage route. No major complications occured during these procedures. After the two stents were inserted in an end-to-side fashion, she was able to eat a normal diet adequately and suffered from no abdominal symptoms and jaundice during the follow-up period of 13 months. These stenting procedures might be less invasive and more useful than surgical treatment and provide long patency of biliary stenting and a good quality of life. [source] Efficacy and Safety of Absorbable Metallic Stents with Adjunct Intracoronary Beta Radiation in Porcine Coronary ArteriesJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2007F.A.C.C., RON WAKSMAN M.D. Background: Absorbable metallic stents (AMS) utilizing Mg alloy carry advantages over permanent metallic stents because of their potential to eliminate stent thrombosis, chronic inflammation, or artifacts with noninvasive imaging. These stents, however, are associated with a modest degree of late recoil and intimal hyperplasia. The aim of the study was to test whether adjunct vascular brachytherapy (VBT) compared to AMS alone can overcome these limitations. Methods: Juvenile domestic pig coronary arteries underwent implantation of either AMS (n = 11) with prior adjunct VBT utilizing Sr/Y-90 , source seeds, with a dose of 24 Gy at 2 mm from the source, or AMS alone (n = 11). At 28 days following intravascular ultrasound, vessels were harvested and analyzed by histomorphometry. Results: Intravascular ultrasound analysis indicated that at follow-up, though statistically not significant, lumen and stent areas in the segments deployed with AMS following radiation were larger than those deployed with AMS alone (3.94 ± 1.38 and 3.53 ± 1.75 vs. 2.99 ± 1.05 and 3.58 ± 1.48). Extrastent plaque and intrastent plaque areas in the same segments were smaller (2.76 ± 0.82 and 0.24 ± 0.47 vs. 3.25 ± 1.94 and 0.58 ± 0.81). Morphometric data indicate that vessels in the VBT + AMS group showed characteristics of delayed healing and re-endothelialization. Neointimal area was significantly lower in the VBT + AMS group (0.49 ± 0.34) compared to AMS (1.3 ± 0.62, P = 0.001). Lumen area of the VBT + AMS was larger when compared with AMS alone (2.49 ± 0.82 vs. 1.75 ± 0.51, P = 0.02). Conclusion: VBT as an adjunct to AMS further reduces the intimal hyperplasia and improves the lumen area when compared to AMS alone but does not have any impact on late recoil. [source] EXPERIENCES OF SELF-EXPANDABLE METALLIC STENT FOR COLORECTAL OBSTRUCTIONS: 70 CASESDIGESTIVE ENDOSCOPY, Issue 2004Yoshihisa Saida ABSTRACT Clinical utilization of self-expandable metallic stent (EMS) endoprosthesis has come later for colorectal diseases than for other lesions. Recently, EMS has been used for palliative insertions for strictures caused by malignant diseases or as a ,bridge to surgery' for obstructive colorectal cancers, with good clinical results increasingly reported in many western countries. Its application for benign strictures has been reported, but we believe that the surgical indications require more careful analysis because of the absence of data concerning long-term prognosis. The advantage of this technique in the treatment of colorectal strictures is that it limits invasiveness, such as in palliative or temporary stoma creation, thereby improving patient quality-of-life. Therefore, we believe that EMS endoprosthesis will play a key role in this field. We are awaiting the introduction of the metallic stent for the colon and the associated kit, as well as the Japanese government's approval for reimbursement for this procedure. [source] Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of VaterDIGESTIVE ENDOSCOPY, Issue 4 2000Hitoshi Sano We have reported successful implantation of self-expandable metallic stents for palliative treatment in a case of an 87-year-old female patient with carcinoma of the papilla of Vater. She suffered from both duodenal and biliary stenoses, but refused surgical treatment. For the duodenal stenting, a self-expandable knitted nitinol metallic stent, for esophageal use, was inserted endoscopically. For the biliary stenting, a self-expandable metallic stent, partially polyurethane-covered on the proximal part to prevent tumor ingrowth and overgrowth, was inserted via the percutaneous transhepatic biliary drainage route. No major complications occured during these procedures. After the two stents were inserted in an end-to-side fashion, she was able to eat a normal diet adequately and suffered from no abdominal symptoms and jaundice during the follow-up period of 13 months. These stenting procedures might be less invasive and more useful than surgical treatment and provide long patency of biliary stenting and a good quality of life. [source] Temporary self-expanding metallic stents and pneumatic dilation for the treatment of achalasia: a prospective study with a long-term follow-upDISEASES OF THE ESOPHAGUS, Issue 5 2010Y.-D. Li SUMMARY The present study compares the efficacy of a self-expanding metallic stent (SEMS, diameter of 30 mm) and pneumatic dilation for the long-term clinical treatment of achalasia. A total of 155 patients diagnosed with achalasia were allocated for pneumatic dilation (n= 80, group A) or a temporary, 30-mm diameter SEMS (n= 75, group B). The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4,5 days after placement. Data on clinical symptoms, complications, and long-term clinical outcomes were collected, and follow-up observations were performed at 6 months and at 1, 3,5, 5,8, 8,10, and >10 years, postoperatively. Pneumatic dilation and stent placement were technically successful in all of the patients. There were no significant differences in technique success, 30-day mortality, or complications between the two groups. The clinical remission rate in group A was significantly lower than that in group B at 1, 1,3, 3,5, 5,8 and, >10 years (P < 0.05), while the cumulative clinical failure rate in group A (66%, 53/80) was higher than that in group B (92%, 6/75). The mean primary patency in group B was significantly longer than that in group A (4.2 vs 2.1 years, respectively; P < 0.001). A temporary, 30-mm diameter SEMS was associated with a better long-term clinical efficacy in the treatment of patients with achalasia as compared with treatment with pneumatic dilation. [source] Use of balloon-expandable metallic stent in a premature infant with congenital tracheobronchial stenosisPEDIATRIC PULMONOLOGY, Issue 4 2008Birgin Törer MD A congenital tracheobronchial stenosis is a rare obstructive lesion of the airway characterized by intrinsic narrowing of a segment of the trachea and bronchi. In this report, we present the smallest premature infant with a congenital tracheobronchial stenosis who has been successfully treated with balloon dilatation and placement of a balloon-expandable metallic stent. Pediatr Pulmonol. 2008; 43:414,417. © 2008 Wiley-Liss, Inc. [source] Examination of expandable metallic stent removed at autopsyRESPIROLOGY, Issue 4 2003Yoshifumi HOSOKAWA Objective: We evaluated the damage to expandable metallic stents (EMS) based upon analysis of EMS removed at autopsy. Methodology: Seventeen EMS were obtained during autopsy from the main bronchi of nine patients with lung cancer. Each EMS was categorized into one of the following three groups, according to the degree of EMS damage: no damage at all (ND), damage to part of the EMS (PD), and marked damage (MD) that caused loss of function of the airway stent. The removed EMS were examined using a scanning electron microscope. Results: Of the 17 stents, ND occurred in 13 (7/9 primary, 6/8 secondary), PD in four (all secondary), and MD in none. None of the stents had completely lost the ability to function as an airway stent. Bacterial biofilm formation (BBF) was detected on EMS from four patients. Conclusions: Bacterial biofilm forms on EMS implanted into the airway. Some physical damage was present in four of 17 EMS, but all remained functional. [source] Outflow block secondary to stenosis of the inferior vena cava following living-donor liver transplantation?CLINICAL TRANSPLANTATION, Issue 2 2005Shugo Mizuno Abstract:, Although it is well known that outflow block is caused by stenosis or occlusion of hepatic vein anastomoses following living donor liver transplantation (LDLT), there have been few reports on inferior vena cava (IVC) stenosis following LDLT. In this paper, we report two cases of IVC stenosis and hepatic vein outflow block following right hepatic LDLT in the absence of stenosis of any of the anastomoses. Both patients presented with liver dysfunction, an ascitic fluid volume of approximately 2000 mL, and congestion in their biopsy specimens, and venocavography demonstrated IVC stenosis with gradients of more than 10 mmHg in patients with a dominant inferior right hepatic vein (IRHV) anastomosis. After a Gianturco expandable metallic stent successfully implanted in the IVC, the patient's liver function recovered and the volume of ascitic fluid decreased. The pathogenesis of hepatic vein outflow block secondary to IVC stenosis following LDLT may involve the anastomosis with the IRHV, which is the dominant draining vein of the graft and larger than the RHV, caudal to the IVC stenosis and a significant IVC pressure gradient that results in increased IRHV pressure. In conclusion, it is important to include hepatic vein outflow block in the differential diagnosis when patients who have undergone right hepatic LDLT in which anastomosis of the large IRHV has been performed develop manifestations of liver dysfunction. [source] ENDOSCOPIC MANAGEMENT OF BILIARY STRICTURESDIGESTIVE ENDOSCOPY, Issue 2004Yoshitsugu Kubota ABSTRACT Endoscopic stenting, due to being less invasive, is feasible for most patients with biliary strictures; however, presumed efficacy should be balanced against the procedure-related morbidities for an individual patient. Self-expandable metallic stents have a longer patency, but are not retrievable. Therefore, the use of self-expandable metallic stents should be limited to those with unequivocal findings of unresectable malignancy. Plastic stents are indicated for strictures due to benign etiologies and equivocal malignancy. Endoscopic stenting for hilar biliary stricture is challenging. Bilateral hepatic drainage seems ideal but is often demanding to achieve with endoscopic technique, and contrast injection into undrained segments may pose a substantial risk for cholangitis and aggravate prognosis. Therefore, the extent of drainage should be balanced against the procedure-related complications. Preoperative magnetic resonance cholangiopancreatography may help determine feasibility of bilateral drainage or an ,intended and selective drainage' with a single stent and might obviate the possible morbidities. [source] Endoscopic removal of a dislocated covered wallstent using a wire-loop techniqueDIGESTIVE ENDOSCOPY, Issue 4 2003Takao Itoi Background:, Self-expandable metallic stents (SEMS) and covered-SEMS (cSEMS) are used for patients with unresectable malignant biliary strictures. Occasionally, there are cases where stent migration can easily occur. Methods and Results:, We experienced a dislocated distal cSEMS that was unable to be removed by previously described techniques. However, we could successfully remove cSEMS with a wire-loop technique using a polypectomy snare and guidewire. Conclusion:, This technique may provide hope for the removal of severely dislocated cSEMS. [source] Combined Use of Uncovered Duodenal and Covered Biliary Metallic Stent for Carcinoma of the Papilla of VaterDIGESTIVE ENDOSCOPY, Issue 4 2000Hitoshi Sano We have reported successful implantation of self-expandable metallic stents for palliative treatment in a case of an 87-year-old female patient with carcinoma of the papilla of Vater. She suffered from both duodenal and biliary stenoses, but refused surgical treatment. For the duodenal stenting, a self-expandable knitted nitinol metallic stent, for esophageal use, was inserted endoscopically. For the biliary stenting, a self-expandable metallic stent, partially polyurethane-covered on the proximal part to prevent tumor ingrowth and overgrowth, was inserted via the percutaneous transhepatic biliary drainage route. No major complications occured during these procedures. After the two stents were inserted in an end-to-side fashion, she was able to eat a normal diet adequately and suffered from no abdominal symptoms and jaundice during the follow-up period of 13 months. These stenting procedures might be less invasive and more useful than surgical treatment and provide long patency of biliary stenting and a good quality of life. [source] Temporary self-expanding metallic stents and pneumatic dilation for the treatment of achalasia: a prospective study with a long-term follow-upDISEASES OF THE ESOPHAGUS, Issue 5 2010Y.-D. Li SUMMARY The present study compares the efficacy of a self-expanding metallic stent (SEMS, diameter of 30 mm) and pneumatic dilation for the long-term clinical treatment of achalasia. A total of 155 patients diagnosed with achalasia were allocated for pneumatic dilation (n= 80, group A) or a temporary, 30-mm diameter SEMS (n= 75, group B). The SEMSs were placed under fluoroscopic guidance and removed by gastroscopy 4,5 days after placement. Data on clinical symptoms, complications, and long-term clinical outcomes were collected, and follow-up observations were performed at 6 months and at 1, 3,5, 5,8, 8,10, and >10 years, postoperatively. Pneumatic dilation and stent placement were technically successful in all of the patients. There were no significant differences in technique success, 30-day mortality, or complications between the two groups. The clinical remission rate in group A was significantly lower than that in group B at 1, 1,3, 3,5, 5,8 and, >10 years (P < 0.05), while the cumulative clinical failure rate in group A (66%, 53/80) was higher than that in group B (92%, 6/75). The mean primary patency in group B was significantly longer than that in group A (4.2 vs 2.1 years, respectively; P < 0.001). A temporary, 30-mm diameter SEMS was associated with a better long-term clinical efficacy in the treatment of patients with achalasia as compared with treatment with pneumatic dilation. [source] The use of self-expandable metallic stents for palliative treatment of inoperable esophageal cancerDISEASES OF THE ESOPHAGUS, Issue 1 2010A. Eroglu SUMMARY Most patients with esophageal carcinoma present in the advanced stage die from tumor invasion and widespread metastases. Because radical regimens are not appropriate for the majority of patients, and their expected survivals are as short as to be measured by months, the main aim of therapy is palliation with minimum morbidity and mortality. Among the palliative modalities are surgery, external radiotherapy or brachytherapy, dilatation, laser, photodynamic therapy, bipolar electrocoagulation tumor probe, and chemical ablation. The placement of self-expandable metallic stents is another method that improves dysphagia for these patients. In this study, the aim was to evaluate retrospectively the effectiveness of metallic stents deployed because of inoperable malignant esophageal stenosis and esophagotracheal fistulas. The results of 170 patients with 202 stents administered because of inoperable malignant esophageal stenosis and esophagorespiratory fistula between January 2000 and October 2008 at the Ataturk University, Department of Thoracic Surgery, were investigated. Despite epidemiological and clinical data, information regarding relief of dysphagia and quality of life were also examined. One hundred seventy patients with stents were between 28 and 91 years old (mean age 63.7 years ± 11.4 years). Ninety-seven were male and 73 were female. Stent indications were advanced tumors with distant metastasis (82 cases, 48.2%), unresectable tumors (51 cases, 30%), patients who cannot tolerate surgery or chemoradiotherapy (18 cases, 10.5%), local recurrence after primary therapy (1 case, 0.5%), esophagorespiratory fistulas from tumor or therapy (14 cases, 8.2%), and refusal of surgery (4 cases, 2.3%). Dysphagia scores evaluated by a modified Takita's grading system improved from 3.4 before the procedure to 2.6 afterward. The overall complication rate without chest pain was 31.7% (occurring in 64 cases). Mean survival was 177.7 days ± 59.3 days (2,993 days). Quality-of-life scores (The European Organization of Research and Treatment of Cancer QLQ C30) improved from 73 ± 10.3 (57,85) to 112 ± 12.6 (90,125). In therapy of malignant esophageal obstructions, metallic stents provide a significant improvement in dysphagia and require less frequent re-intervention according to other methods of dysphagia palliation such as dilatation, laser, and photodynamic therapy, nearly completely relieve esophagotracheal fistulas and improve quality of life to an important degree. [source] Self-expandable metallic stents for palliation of malignant esophageal obstruction: special reference to quality of life and survival of patientsDISEASES OF THE ESOPHAGUS, Issue 1 2004K. Yajima SUMMARY., Self-expandable metallic stents (EMS) provide a common option for malignant esophageal stenosis because of the low complication rate and high dysphagia improvement rate. However, there are few studies on the functional duration of EMS and the extent of improvement of the quality of life. We retrospectively analyzed 18 patients who received EMSs in our division from 1996 to 2002. The median duration of possible food intake and the median survival period were 94.5 and 108 days. The median duration of domiciliary treatment was 56 days. Six of the 18 patients were not discharged from hospital after EMS insertion. The Karnofsky index was found to be a significant determinant of the feasibility of domiciliary treatment. One-third of the patients are incapable of obtaining the benefits of the palliative therapy. EMS deployment should be prudently selected for patients exhibiting low performance status. [source] Outcome of self-expandable metallic stents in low-grade versus advanced hilar obstructionJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2008Rungsun Rerknimitr Abstract Background:, Self-expandable metallic stents (SEMS) are known to provide a longer patency time than plastic stents for malignant biliary obstructions including hilar obstruction. However, studies that focus on the efficacy of SEMS in low-grade and advanced hilar obstructions are still scanty. Methods:, Ninety four patients with malignant hilar obstructions were enrolled (six were later excluded). Patients were divided into two groups according to their Bismuth levels. Group A were patients with Bismuth I (n = 53). Group B were patients with Bismuth II, III and IV (n = 35). Technical success, complications, jaundice resolution, stent patency time, and patients' survival were analyzed. Results:, Our intention-to-treat analysis showed that group A had a significant lower rate of post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis than group B; 16.1% versus 44.7%, (P < 0.01). Four patients from group B still had persistent jaundice. Our per protocol analysis demonstrated that median stent patency time in groups A and B were not statistically different (74 vs 60 days). Median survival time in groups A and B were also not statistically different (90 vs 75 days). In both groups, those without liver metastasis had significantly better patency and survival time than those with liver metastasis (P = 0.010 and 0.027, respectively). Conclusions:, In patients with hilar obstruction, liver metastasis is one of the main factors that determine survival of the patient. Patency times of SEMS in both low-grade and advanced obstructions are comparable. However, in the advanced group, there is a significant risk of post-ERCP cholangitis. [source] Efficacy and Safety of Absorbable Metallic Stents with Adjunct Intracoronary Beta Radiation in Porcine Coronary ArteriesJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2007F.A.C.C., RON WAKSMAN M.D. Background: Absorbable metallic stents (AMS) utilizing Mg alloy carry advantages over permanent metallic stents because of their potential to eliminate stent thrombosis, chronic inflammation, or artifacts with noninvasive imaging. These stents, however, are associated with a modest degree of late recoil and intimal hyperplasia. The aim of the study was to test whether adjunct vascular brachytherapy (VBT) compared to AMS alone can overcome these limitations. Methods: Juvenile domestic pig coronary arteries underwent implantation of either AMS (n = 11) with prior adjunct VBT utilizing Sr/Y-90 , source seeds, with a dose of 24 Gy at 2 mm from the source, or AMS alone (n = 11). At 28 days following intravascular ultrasound, vessels were harvested and analyzed by histomorphometry. Results: Intravascular ultrasound analysis indicated that at follow-up, though statistically not significant, lumen and stent areas in the segments deployed with AMS following radiation were larger than those deployed with AMS alone (3.94 ± 1.38 and 3.53 ± 1.75 vs. 2.99 ± 1.05 and 3.58 ± 1.48). Extrastent plaque and intrastent plaque areas in the same segments were smaller (2.76 ± 0.82 and 0.24 ± 0.47 vs. 3.25 ± 1.94 and 0.58 ± 0.81). Morphometric data indicate that vessels in the VBT + AMS group showed characteristics of delayed healing and re-endothelialization. Neointimal area was significantly lower in the VBT + AMS group (0.49 ± 0.34) compared to AMS (1.3 ± 0.62, P = 0.001). Lumen area of the VBT + AMS was larger when compared with AMS alone (2.49 ± 0.82 vs. 1.75 ± 0.51, P = 0.02). Conclusion: VBT as an adjunct to AMS further reduces the intimal hyperplasia and improves the lumen area when compared to AMS alone but does not have any impact on late recoil. [source] Update on Bioabsorbable Stents: From Bench to ClinicalJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2006F.A.C.C., RON WAKSMAN M.D. Permanent metallic stents are associated with limitations such as continued mechanical stress, transfer to the tissue, and continued biological interaction with the surrounding tissue. They are also associated with late stent thrombosis and artifacts when non-invasive technologies such as MRI and MSCT are used. The potential advantages of bioabsorbable polymeric or metallic stents are to leave no stent behind, they are fully compatible with MRI and MSCT imaging, and are not associated with late stent thrombosis. This review covers the different stent programs as they move from bench to bed and clinical trials. Bioabsorbable stents are considered the next frontier of stenting and we will discuss their potential to fulfill this promise in interventional cardiology. [source] Quantitative evaluation of susceptibility and shielding effects of nitinol, platinum, cobalt-alloy, and stainless steel stentsMAGNETIC RESONANCE IN MEDICINE, Issue 5 2003Yi Wang Abstract The purpose of this study is to quantitatively estimate the shielding and susceptibility effects of commonly used metallic stents on MR signal. Two experiments were performed using a 3D gradient echo sequence with short TE to image a stent phantom: 1) short TR and high flip angle (contrast enhanced MRA parameters), and 2) long TR (TR , T1) and low flip angle. The factor characterizing susceptibility effects was estimated from the signal phase of the first experiment, and then the factor characterizing the shielding effects was derived from the second experiment. Susceptibility induced signal loss was negligible (<1%) for nonstainless-steel (nitinol, platinum, and cobalt-alloy) stents and totally destructive (100%) for the stainless steel stent. Signal loss due to RF shielding was 31,62% for nitinol stents, 14,50% for platinum stents, 50,77% for the cobalt-alloy stents (undetermined for the stainless steel stent), varied with stent orientation, diameter, and wall geometry. In summary, stents made of nitinol, platinum, and cobalt-alloy have negligible susceptibility effects but stents made of stainless steel may have complete dephasing. All stents have substantial shielding effects, which vary with composition, geometry, and orientation. Large platinum stents may have the smallest artifacts and are the best suited for postinterventional MR imaging. Magn Reson Med 49:972,976, 2003. © 2003 Wiley-Liss, Inc. [source] Examination of expandable metallic stent removed at autopsyRESPIROLOGY, Issue 4 2003Yoshifumi HOSOKAWA Objective: We evaluated the damage to expandable metallic stents (EMS) based upon analysis of EMS removed at autopsy. Methodology: Seventeen EMS were obtained during autopsy from the main bronchi of nine patients with lung cancer. Each EMS was categorized into one of the following three groups, according to the degree of EMS damage: no damage at all (ND), damage to part of the EMS (PD), and marked damage (MD) that caused loss of function of the airway stent. The removed EMS were examined using a scanning electron microscope. Results: Of the 17 stents, ND occurred in 13 (7/9 primary, 6/8 secondary), PD in four (all secondary), and MD in none. None of the stents had completely lost the ability to function as an airway stent. Bacterial biofilm formation (BBF) was detected on EMS from four patients. Conclusions: Bacterial biofilm forms on EMS implanted into the airway. Some physical damage was present in four of 17 EMS, but all remained functional. [source] Acute malignant colorectal obstruction and self-expandable metallic stentsANZ JOURNAL OF SURGERY, Issue 12 2002Christopher J. Young MB BS No abstract is available for this article. [source] Self expanding wall stents in malignant colorectal cancer: is complete obstruction a contraindication to stent placement?COLORECTAL DISEASE, Issue 8 2009G. J. A. Stenhouse Abstract Objective, Technical failures have previously been associated with complete clinical obstruction and complete block to the retrograde flow of gastrograffin is considered by some to be a contraindication to the procedure. We report on the technical and clinical success rates of self-expanding metallic stents (SEMS) in both complete and incomplete obstruction in a prospective series of malignant colorectal obstructions. Method, A prospective study of all patients undergoing attempted palliative and bridge to surgery SEMS placement for malignant colorectal obstruction over a 7-year period (April 1999,October 2006) was undertaken. Results, Seventy-two patients (49 males) with a mean age of 71 years (range 49,98) were included. Technical success was achieved in 27 of 32 patients (84%) with complete obstruction and 33 of 36 patients (92%) with incomplete obstruction, P < 0.46, Fishers exact test. Clinical success was achieved in 17 of 26 patients (65%) with complete obstruction and 24 of 33 patients (73%) with incomplete obstruction, P < 0.58, Fishers exact test. Although placed correctly in 89% cases, relief of symptoms occurred in only 71%, P = 0.002, matched pairs test. There were two colonic perforations in the series with one procedure related death. Conclusion, Placement of SEMS for obstructing colorectal cancer is technically successful in a high proportion of cases. Complete radiological obstruction is not a contraindication to stent placement. The relief of obstructive symptoms following successful placement of a wall stent is less predictable. [source] | ||||||||||||||||||||||