Enteral stents

Abstract

The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2010 for articles related to enteral, esophageal, duodenal, and colonic stents. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment.

Secondary stent-in-stent self-expanding metallic stent placement for early stent occlusion due to mucosal oedema in the gastrojejunal anastomosis after palliative subtotal gastrectomy for locally advanced gastric cancer

“…Nitinol has increased flexibility, which is helpful for stenting sharply angulated regions, but this is at the cost of a lesser radial force, relative to stents made with other metals. (13) The decision to first use an uncovered stent was due to several reasons. Firstly, most commonly available pyloric or enteral stents are uncovered.…”

Endoscopic Management of Anastomotic Esophageal Strictures Secondary to Esophageal Atresia

“…The current SEPS on the market is made of a woven polyester mesh with a silicon membrane coating to prevent ingrowth of tissue (Polyflex; Boston Scientific Corporation, Marlborough, MA). 59 SEPS are packaged fully expanded and need to be manually loaded onto a delivery system before placement.…”

Endoscopic Treatment of Pancreatic Diseases

“…Endoscopic treatment of duodenal stenosis, due to invasion of PC, includes placement of an SEMS through the duodenoscope (Figure 4) [214,215,234]. The reported success rate is 92%-100% and rapid alimentary recovery (usually within 24 h) occurs in 75%-93% of cases [217].…”