Recent Advances in Gastrointestinal Stent Development

Park, Jin-Seok; Jeong, Seok; Lee, Don Haeng

doi:10.5946/ce.2015.48.3.209

Cited by 35 publications

(28 citation statements)

References 60 publications

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“…Consequently, plastic stents have rarely been used since the 1990s when uncovered SEMS first became available. SEMS are generally packaged in a compressed form and constrained around a delivery device, making dilation unnecessary and reducing the risks of perforation, obstruction, or migration, which can occur with plastic stents [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer

Orii

Karasawa

Kitahara

et al. 2016

Case Rep Gastroenterol

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Because of advances in the technology of gastrointestinal endoscopy and improvements in the quality of stents, it has become routine to place a stent as palliative therapy for malignant gastrointestinal obstruction. On the other hand, stent placement for malignant gastrointestinal hemorrhage has scarcely been reported, although it may be performed for hemorrhage of the esophageal varicose vein. We recently experienced a patient with refractory hemorrhage from an unresectable duodenal cancer who underwent placement of a self-expandable metallic stent (SEMS) and thereafter had no recurrence of the hemorrhage. A 46-year-old man underwent laparotomy to radically resect a cancer in the third portion of the duodenum, which invaded widely to the superior mesenteric vein and its branches and was considered unresectable. After stomach-partitioning gastrojejunostomy was performed, chemotherapy was initiated according to the regimen of chemotherapy of far advanced gastric cancer. One year and 4 months after induction of chemotherapy, gastrointestinal hemorrhage occurred. Upper gastrointestinal endoscopy revealed the hemorrhage oozing from the duodenal cancer, and endoscopic hemostasis, such as injection of hypertonic saline epinephrine and argon plasma coagulation, was unsuccessful. Twenty days after emergence of the hemorrhage, an endoscopic covered SEMS was placed with confirmation by fluoroscopy. Immediately after placement of the stent, the tarry stool stopped and the anemia ceased to progress. The recurrence of the hemorrhage has not been confirmed without migration of the stent. SEMS is an effective hemostatic procedure for malignant refractory hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer

Orii

Karasawa

Kitahara

et al. 2016

Case Rep Gastroenterol

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“…With FCSEMS, migration is a major problem. Several newly designed stents prevent stent migration; anchoring flaps or flared stent ends are commonly used [ 67 , 68 ]. Studies using FCSEMS with either an anchoring flap or a flared end at the proximal end of the stent reported that the anchoring flap design might be superior in terms of efficacy and a lower migration rate to the flared end [ 69 , 70 ].…”

Section: Novel Stentsmentioning

confidence: 99%

Current Status of Biliary Metal Stents

Nam

Kang

2016

Clin Endosc

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Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. In this article, we briefly review the characteristics of SEMS as well as complications of stent placement. We review the current guidelines for managing malignant and benign biliary obstructions. Recent developments in biliary stenting are also discussed.

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“…Accurate stent positioning, establishing and maintaining luminal patency, and limiting stent migration and adjacent tissue injury are important considerations in the selection and placement of an SEMS. Data on existing SEMSs suggest that stent design can impact clinical success [3-6]. In 2019, the HANAROSTENT® LowAx TM Duodenum (Olympus Corporation of the Americas, Center Valley, PA, USA) was approved by the US Food and Drug Administration (FDA) for palliative treatment of pyloric or duodenal obstructions by malignant neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Luminal Stenting: The Early US Experience with the Duodenal HANAROSTENT

Fung

Kadera

Tabibian

2020

Gastrointest Tumors

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Self-expandable metal stents (SEMSs) are frequently utilized for palliation of malignant gastric and/or duodenal outlet obstruction (GDOO). Re-establishing luminal patency with accurate SEMS positioning while limiting migration and adjacent tissue injury is an important technical consideration and aim. The duodenal HANAROSTENT® was introduced in the USA in 2019 and developed with these challenges in mind. As the first center in the USA to deploy the duodenal HANAROSTENT® in clinical practice, we herein examine our early experience with its use. Specifically, we describe 7 consecutive cases of malignant GDOO in which a duodenal HANAROSTENT® was placed for on-label use, defined as palliative treatment of malignant gastric and/or duodenal obstruction. All stents were 22 mm in diameter, with 5 being 90 mm and 2 being 120 mm in length. Technical and clinical success with duodenal HANAROSTENT® placement were achieved in all 7 cases (100%). In no case was stent adjustment required post-deployment. There were no stent-related adverse events, and no subsequent endoscopic procedures were necessary in any of the patients during a mean follow-up of 5 months (range 1–12 months). In summary, the duodenal HANAROSTENT® appears to perform well and be a promising alternative to other available duodenal SEMSs. As experience in the USA with this newly introduced duodenal SEMS grows, multicenter prospective data should be collected to better establish its relative safety and efficacy.

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Recent Advances in Gastrointestinal Stent Development

Cited by 35 publications

References 60 publications

Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer

Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer

Current Status of Biliary Metal Stents

Gastrointestinal Luminal Stenting: The Early US Experience with the Duodenal HANAROSTENT

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