Coated <i>v</i> Noncoated Ureteral Metal Stents: An Experimental Model

Liatsikos, Evangelos; Siablis, Dimitrios; Kalogeropoulou, Christina; Karnabatidis, Dimitrios; Triadopoulos, Alexis; Varaki, Lili; Zabakis, Petros; Perimenis, Petros; Barbalias, George A.

doi:10.1089/08927790152596361

Cited by 17 publications

(9 citation statements)

References 17 publications

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“…Metal stent complications mainly arise because of ureteral obstruction by tissue ingrowths 13, 14. In light of this, several authors have investigated the use of coated metal stents designed to prevent tissue ingrowths 3. Despite the reduced urothelial ingrowths with the Dacron coated stents, a pronounced inflammatory reaction or tissue necrosis surrounding the stents was reported.…”

Section: Discussionmentioning

confidence: 99%

“…In light of this, a number of metallic stents, such as the Nitinol self‐expandable stent, were introduced in clinical practice. These stents, however, are associated with a high rate of migration, stone encrustation, and obstruction because of urothelial ingrowths 2, 3. To prevent the hyperplastic reaction associated with this kind of stent, Dacron coated metallic stent were used with promising results4 to further increase the effectiveness of double J stent.…”

Section: Introductionmentioning

confidence: 99%

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Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

2010

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We report the first preliminary study on metal-alloy ureteral stent after long indwelling times. The aim is to analyze by physical-chemical characterization of the stent after use and to evaluate the material performance in this human in vivo case study. Six Resonance metallic stents (Cook Ireland) were inserted in six patients for 6, 10, 11, 12, 24, and 36 months. The stents were then collected and studied by Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive Spectroscopy (EDS), gaining information about the metal stent surface and the amount and nature of the formed encrustation. The stents were all draining adequately, despite the presence of the bacterial biofilm layer in all stents. This layer was more dense and compact as the indwelling time increased. Some slight precipitation of inorganic compounds, such as brushite and calcium oxalate was observed. No epithelial tissue in growth was recorded. These preliminary results with Resonance metallic ureteral stents suggest the feasibility of a long-term approach in patients with chronic ureteral obstruction. The durability of the metal stent, the lack of epithelial tissue ingrowths and limited pain or discomfort to patients were proven over long time periods. The long-term use of these stents is therefore feasible, avoiding the continuous exchange of the stent, decreasing hospital costs and increasing the quality of life of patients affected by malignant pelvic tumors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

2010

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“…5 Since then several types of metal stents have been manufactured and used successfully for the treatment of extrinsic malignant and benign ureteral strictures. [6][7][8][9] The characteristics of metal stents commonly used in the clinic are stated in Table 2. In China, metal stents were first used in 1995, 10 and in 2000 we reported our preliminary results of treating benign upper urinary tract occlusion with metal stents.…”

Section: Discussionmentioning

confidence: 99%

“…Balloon-expandable No Tubular mesh configuration, made of tantalum monofilament, fully expanded to a diameter of 10 mm. Passager 8 Self-expandable Yes Nitinol mesh stent externally covered with ultrathin woven polyester fabric, 4 or 6 cm long, fully expanded to a diameter of 8 mm. Memokath 051 9 Thermo-expandable No Unique shape-memory, made from an alloy of titanium and nickel.…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of permanent metallic stent implantation in the treatment of benign upper urinary tract occlusion

Yuan

et al. 2007

Int J of Urology

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Aim:The management of complicated benign upper urinary tract occlusion is extremely challenging, especially in patients unable to undergo an open operative procedure. We report the long-term results of a permanent metallic stent for benign upper urinary tract occlusion. Methods: From October 1995 to December 1998, 13 patients (8 men and 5 women, with a mean age of 43 years) with benign upper tract occlusion have been treated by metallic stent implantation. All patients had a nephrostomy tube to relieve the obstruction and the average time of the nephrostomy tube stay was 27 months, ranging from 3 to 131 months. The average length of occlusion was 2.7 cm, ranging from 1 to 3.6 cm. Ultrasonography, urography, diuresis renography and urine culture were performed every 3 months after stent insertion. Ureteroscopy was done when needed. Results: The mean follow-up was 92 months (12-132 months). Ureteral patency was achieved in six patients and assisted patency with a Double-J stent was achieved in three patients. In two patients the kidney had to be removed because of progressive malfunction and in two patients the metal stent had to be extracted with the Holmium: YAG laser, burning it down due to the uncontrollable pyonephrosis. In three patients the ipsilateral flank pain recurred. One of these patients experienced urine leakage due to the initial nephrostomy tract: a ureteroscopy revealed a complete hyperplastic urothelial response. Proximal stone formations were found in 2 patients and all were removed by percutaneous nephrolithotomy (PCNL). No stent migration or fragmentation was observed. Conclusion:The implantation of metal stent is a safe and effective treatment for benign upper urinary tract occlusion, and has satisfying long-term outcome in selected cases. A further investigation is needed for its impact on the urodynamics of upper urinary tract.

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“…In our series permanent ureteral wall stents have been effective in maintaining a patent lumen with a 75% success rate in patients who had previously been treated with endoureterotomy which had failed. Uroepithelial ingrowth into the lumen of the stents and/or development of fi brous tissue beneath the stent have been the principal problem with the placement of the ureteral wall stents [14] . In our series, only in 1 patient did such a hyperplastic reaction jeopardize the patency of the ureteral lumen.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Treatment of Ureteric Strictures: Acucise, Cold-Knife Endoureterotomy and Wall Stents as a Salvage Approach

et al. 2005

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Objective: To evaluate the factors influencing the results of endoureterotomy using cold-knife and cutting balloon dilatation, and permanent ureteral wall stents in patients with benign ureteral strictures after different operations affecting the ureter. Materials and Methods: Over a 4-year period, in 18 patients, endoscopic cold-knife and Acucise endoureterotomies were performed in 13 and 7 renal units, respectively. Eight Memoterm permanent ureteral wall stents were inserted into 7 patients when endoureterotomy failed. Successful outcome was defined by the absence of re-stricture assessed both clinically and radiologically. Results: The strictures were secondary to ureterolithotomy in 6, ureteroscopy in 3, gynecological procedures in 4, abdominal surgeries in 2, transplantation in 2 and continent urinary diversion in 1. The right and left ureters were unilaterally affected in 5 and 11 patients, respectively (5 of them had a solitary kidney), while the remaining 2 patients had bilateral ureteral strictures. We achieved total ureteral patency of 3 (43%) and 7 (54%) renal units with Acucise and cold-knife incision, respectively. Obstructive uropathy was resolved in 6 renal units (75%) of 8 using ureteral wall stents. Conclusion: Endoureterotomy with cold-knife or Acucise cutting balloon dilatation is effective in the treatment of iatrogenic ureteral strictures, but only in a selected group. Based on our results, the favorable prognostic criteria for endoureterotomy are the length (≤1.5 cm), the nonischemic nature of the stricture and adequate renal function. As a salvage approach, permanent self-expanding ureteral wall stents with a 75% success rate may provide a satisfactory outcome for decompression of an obstructed system.

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Coated v Noncoated Ureteral Metal Stents: An Experimental Model

Abstract: Our experimental results suggest that the standard Wallstent generates less inflammation of the surrounding tissues than coated stents. The coated stents have the advantage of minimal tissue ingrowth but have a tendency to migrate toward the bladder.

Cited by 17 publications

References 17 publications

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

Ni‐Cr‐Co alloy ureteral stent: Scanning electron microscopy and elemental analysis characterization after long‐term indwelling

Long‐term results of permanent metallic stent implantation in the treatment of benign upper urinary tract occlusion

Endoscopic Treatment of Ureteric Strictures: Acucise, Cold-Knife Endoureterotomy and Wall Stents as a Salvage Approach

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