Diamond Stents for Palliation of Malignant Bile Duct Obstruction: A Prospective Multicenter Evaluation

Ferlitsch, Arnulf; Oesterreicher, Christian; Dumonceau, Jean‐Marc; Devière, Jacques; Leban, Tanja; Born, Peter; Rösch, Thomas; Suter, Walter; Binek, Janek; Meyenberger, Christa; Müllner, Maximilian; Schneider, B; Schöfl, R

doi:10.1055/s-2001-16214

Cited by 43 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[10][11][12] However, despite improvements in materials and stent design, problems remain, as exemplified by the 13% to 44% reintervention rate attributed to stent failure with SEMSs. [13][14][15][16] A number of factors have been suggested to explain this relatively high failure rate, including epithelial hyperplasia, tumor ingrowth and overgrowth, dislocation, debris formation, and clot accumulation. 1,17,18 To better counteract tumor ingrowth in uncovered SEMSs (uSEMSs), covered SEMSs (cSEMSs) were developed by placing a thin nonporous membrane on the inside of the metal mesh.…”

mentioning

confidence: 98%

Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study

Kullman¹,

Frozanpor²,

Söderlund³

et al. 2010

Gastrointestinal Endoscopy

282

232

View full text Add to dashboard Cite

mentioning

confidence: 98%

Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study

Kullman¹,

Frozanpor²,

Söderlund³

et al. 2010

Gastrointestinal Endoscopy

282

232

View full text Add to dashboard Cite

“…Although aIl studies used the uncovered WaIlstent® SEMS, recent RCTs suggested aIl uncovered stents are equally effective [135,136]. It is also clear that patients treated with uncovered SEMS are less likely to be hospitalized and require endoscopie reintervention due to stent dysfunction; it certainly has an economical impact that is related to the local standards and costs.…”

Section: Self-expandable Metal Stentsmentioning

confidence: 99%

Cost-Effectiveness Decision Analyses Comparing Covered to Uncovered Self-Expandable Metal Stents to Elective or on Demand Polyethylene Stent Changes in Patients with Distal Malignant Biliary Obstruction

Silveira¹,

Waschke²,

Barkun³

et al. 2005

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

“…Nonetheless, SEMS do eventually occlude in 19-40 % of patients [3][4][5]. The duration of SEMS patency has remained largely unchanged in spite of modifications in stent composition and the addition of a plastic coating [7][8][9]. Thus, a clear need exists for technologic improvements that minimize stent occlusion.…”

mentioning

confidence: 99%

Drug-Eluting Stents in Malignant Biliary Obstruction: Where Do We Stand?

Shah

2012

Dig Dis Sci

View full text Add to dashboard Cite

In patients with malignant biliary obstruction, endoscopic placement of biliary stents offers similar technical success rates but a lower risk of complications and a trend towards decreased mortality when compared to surgical bypass and percutaneous drainage [1,2]. As a result, over the last three decades, endoscopic retrograde cholangiography (ERC)-guided stent placement has become the preferred approach to palliate malignant biliary obstruction.Until the 1990s, only plastic stents were available. Plastic stents may occlude within 3-6 months, often requiring repeated ERC procedures in order to exchange the stents. The introduction of a stainless-steel uncovered metal stent (Wallstent, Boston Scientific) heralded a major advance in extending the duration of stent patency. Although self-expandable metallic stents (SEMS) are more expensive than plastic stents, they are cost-effective when compared to plastic stents for patients expected to live longer than 3 months due to the need for fewer subsequent ERC procedures [1,[3][4][5][6]. Nonetheless, SEMS do eventually occlude in 19-40 % of patients [3][4][5]. The duration of SEMS patency has remained largely unchanged in spite of modifications in stent composition and the addition of a plastic coating [7][8][9]. Thus, a clear need exists for technologic improvements that minimize stent occlusion.The major mechanisms of SEMS occlusion are tumor ingrowth, tumor overgrowth, and epithelial hyperplasia. These mechanisms provide the rationale for developing a stent that is coated with or locally elutes a chemotherapeutic agent in order to improve stent patency. In vitro and animal studies suggest that a paclitaxel-coated stent may be safe and potentially efficacious when used for malignant biliary obstruction. Kalinoswki et al. [10] demonstrated that incubation with paclitaxel inhibited proliferation of human gallbladder cells, human fibroblasts, and pancreatic cells in a dose-dependent fashion. In a porcine model, SEMS coated with a paclitaxel-incorporated membrane were not associated with transmural necrosis or perforation [11]. Paclitaxel-eluting stents also appear to be safe in a canine model [12].Limited data exist regarding outcomes of paclitaxeleluting stents for malignant biliary obstruction in humans. In a pilot study of 21 humans with malignant biliary obstruction, SEMS coated with a paclitaxel-incorporated membrane remained patent for a mean of 429 days (cumulative patency rate at 3, 6, and 12 months of 100, 71, and 36 %, respectively) [13]. The pilot study suggests a paclitaxel-coated SEMS may provide longer patency rates than the 10-12 months provided by standard uncovered or covered SEMS and informed the author's decision to proceed with a larger prospective study [1].The current study by the same investigators is a prospective comparison of standard covered SEMS to SEMS covered by a paclitaxel-incorporated membrane [14]. Stents were 5-8 cm in length and 10 mm in diameter in both groups. The authors initially planned the study as a randomized controlled trial...

show abstract

Diamond Stents for Palliation of Malignant Bile Duct Obstruction: A Prospective Multicenter Evaluation

Abstract: The Diamond stent compares favorably with other biliary metal stents for patients requiring biliary drainage of malignant jaundice.

Cited by 43 publications

References 10 publications

Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study

Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study

Cost-Effectiveness Decision Analyses Comparing Covered to Uncovered Self-Expandable Metal Stents to Elective or on Demand Polyethylene Stent Changes in Patients with Distal Malignant Biliary Obstruction

Drug-Eluting Stents in Malignant Biliary Obstruction: Where Do We Stand?

Contact Info

Product

Resources

About