Human tissue responses to metal stents implanted in vivo for the palliation of malignant stenoses

Endoscopic removal of self-expandable metal stents from the esophagus (with video)

“…Two previous studies have reported its mechanism: initially, pressure necrosis is caused by the radial force of the stent, leading to migration of the struts of the stent into the mucosa and submucosa, followed by a chronic lymphocytic inflammatory reaction, mucosal hyperplasia, and subsequent fibrosis. 45,46 Although tissue ingrowth is beneficial for preventing stent migration, it makes removal complex and challenging. Jaganmohan and Raju 15 reported that fully covered SEMSs can also become embedded in the esophageal wall; this was also encountered in 1 case in our series.…”

Indications and results of endoscopic rectal stenting

“…1 Tissue reactions to SEMS in vivo are known based on animal data as well as autopsy and surgical findings in humans. 2 Histologic findings specifically related to rectal self-expandable metal stents has been reported on two occasions. 3,4 Once deployed, the tissue response to SEMS seems to be consistent throughout the gastrointestinal tract.…”

Removable, Fully Covered, Self-expandable Metal Stents for the Treatment of Refractory Benign Esophagogastric Anastomotic Strictures

“…The use of metal stents for palliation of malignant esophageal strictures is well accepted [12,13] but remains controversial for the treatment of benign diseases. In previous studies, noncovered metal stents were not routinely used for benign esophageal obstruction because of a high incidence of stent-induced trauma leading to fistulization and stent-induced stenosis caused by granulation tissue and fibrosis, as well as difficulty in being able to reliably remove the stents [14,15]. Due to the clinical application of RFCSEMSs, these problems have been resolved in large part.…”