Measurement of radial and axial forces of biliary self-expandable metallic stents

Isayama, Hiroyuki; Nakai, Yousuke; Toyokawa, Yoshihide; Togawa, Osamu; Gon, Chimyon; Ito, Yukiko; Yashima, Yoko; Yagioka, Hiroshi; Kogure, Hirofumi; Sasaki, Takashi; Arizumi, Toshihiko; Matsubara, Saburo; Yamamoto, Natsuyo; Sasahira, Naoki; Hirano, Keisuke; Tsujino, Takeshi; Toda, Nobuo; Tada, Minoru; Kawabe, Takao; Omata, Masao

doi:10.1016/j.gie.2008.09.032

Cited by 198 publications

(229 citation statements)

References 23 publications

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“…The patency of a SEMS deployed for patients with biliary stricture is related to its axial force, which is connected with kinking of the bile duct (29). Similarly, the use of SEMSs with a low axial force for patients with malignant GOO is thought to be likely to decrease the risk of stent dysfunction caused by kinking because of the angulation of the duodenum.…”

Section: Metallic Stents With Different Axial Forcesmentioning

confidence: 99%

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

2017

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Gastric outlet obstruction (GOO) is one of severe comorbidities caused by many kinds of malignant diseases and is associated with not only degradation of patients' quality of life but also mortality. Although surgical bypass is one of the main therapies for malignant GOO, it is often difficult to perform in end-stage patients. The deployment of self-expandable metallic stents (SEMSs) has recently become a viable alternative to surgical bypass for malignant GOO. This technique is less invasive and more effective, particularly in patients with poor prognoses.Many reports have referred to the feasibility, effectiveness, and safety of the placement of SEMSs for malignant GOO. According to these reports, the rates of technical and clinical success were reported to be relatively high and the rate of adverse events to be acceptable. However, precautions against severe adverse events such as massive bleeding and perforation are necessary. Several reports have described the differences in clinical results among different kinds of SEMSs. The presence of a covered design for SEMSs may affect the patency of SEMSs and the rate of stent dysfunction. Selection of the SEMS according to axial force may affect successful achievement of long patency of SEMSs and avoidance of gastroduodenal perforation at the bending site of the duodenum. Compared with high technical success rates nearing 100%, clinical success rates were usually lower than technical success. Therefore, determination of predictive factors for failure of clinical success is important. Several papers reported that low performance status could be associated with failure of clinical success. However, the association of clinical success with other factors such as carcinomatosa and ascites remains controversial, which is a problem to be solved.Reintervention with SEMS using the stent-in-stent method after stent dysfunction can be performed effectively as well as placement of the first SEMS.

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Section: Metallic Stents With Different Axial Forcesmentioning

confidence: 99%

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

2017

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“…There is also a complicated, wire-braided type of SEMS structure. 3 This type of SEMS consists of two layers of wire-crossover structure with or without an intervening covering membrane. The braided structure of the stent has closed cells and is more resistant to tumor ingrowth or inward tissue hyperplasia compared to the open cell type of stent.…”

Section: Basic Structure Of Sems Wirementioning

confidence: 99%

“…3,[14][15][16][17][18][19] One of the most important factors is RF because it expands and maintains the lumen at the stricture segment of the bile duct after the SEMS are deployed. The force can be influenced by the wire diameter, cell size (which depends on how close the wire is woven), and the wire-knitting method (braided, specially braided, or laser cut …”

Section: Mechanical Properties Ofsemsmentioning

confidence: 99%

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

Yang¹,

Moon²,

You³

et al. 2016

Korean J Pancreas Biliary Tract

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Biliary self-expandable metal stents (SEMS), a group of non-vascular stents, have been used in the palliative management of biliary obstruction around the world. However, there are still unmet needs in the clinical application of biliary SEMS. Comprehensive understanding of the SEMS is required to resolve the drawbacks and difficulties of metal stent development. The basic structure of SEMS, including the materials and knitting methods of metal wires, covering materials, and radiopaque markers, are discussed in this review. What we know about the physical and mechanical properties of the SEMS is very important. With an understanding of the basic knowledge of metal stents, hurdles such as stent occlusion, migration, and kinking can be overcome to develop more ideal SEMS.

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“…[17][18][19][20] Although shortening ratio and radiopacity are mechanical features associated with stent insertion process, radial expansion force and recovery force are important factors associated with the stent patency and dysfunction after its insertion. 21 The extent of radial expansion force mainly depends on the material type and thickness of the metal alloy wire, number of wire bends, and method of weaving the wire. If the radial expansion force is weaker than the pressure of the tissues surrounding the stricture area, the stent fails to achieve its expected expansion, which may then lead to stent migration or occlusion.…”

Section: 폴리머 제38권 제3호 2014년mentioning

confidence: 99%

“…An excessively strong recovery force often results in dysfunctional stents, including those observed as stent kinking, stent migration, or causing injury to the adjacent tract inner wall and production of bile sludge. 21 The ideal stent, thus, possesses a strong radial expansion force and a weak recovery force.…”

Section: 폴리머 제38권 제3호 2014년mentioning

confidence: 99%

Physical Properties of Covered Stent in Gastric Acid Environment: In Vitro Study

Park¹,

Park²,

Kim³

et al. 2014

Polymer Korea

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In membrane covered stent, occlusion and fracture from membrane degradation by gastric acid sometimes occurred. Therefore, we investigated the physical properties of membrane covered stent according to its ingredient and concentration in gastric acid environment. Membrane covered stents consisted of silicone and polyurethane with 15%, 18%, 20% concentrations were used. After incubating stents in a condition of pH 1.2, we checked any changes at every 3 weeks for 18 weeks. The changes of membrane surface, radial expansion and recovery force of stent were investigated. Coating thickness increased proportionally to an increase in ingredient concentration. Surface was evenly coated with silicone compared to the case with polyurethane and its homogeneity was excellent in a high concentration. Degradation was much severe in the case of polyurethane. The radial force of silicone was higher than polyurethane, and the decrease of radial and recovery force was higher in the case of polyurethane. In conclusion, high concentration of silicone membrane was more stable than polyurethane in acid environment of in vitro study.

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Measurement of radial and axial forces of biliary self-expandable metallic stents

Cited by 198 publications

References 23 publications

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

Physical Properties of Covered Stent in Gastric Acid Environment: In Vitro Study

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