Self-expanding endovascular prosthesis: an experimental study.

Rousseau, H.; Puel, Jacques; Joffre, F.; Sigwart, Ulrich; Duboucher, Christophe; Imbert, Christelle; Knight, C T; Kropf, L; Wallsten, H

doi:10.1148/radiology.164.3.3303120

Cited by 233 publications

(52 citation statements)

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“…The early experimental work on the use of a new self expanding endovascular prosthesis was reported by Rousseau et al [1]. The technique was extended by Mil roy et al [2] who described their experience with the same stent in the normal dog urethra and in the first 8 patients, and by Sarramon et al [3] who reported healing after placing spring stents into the urethra of dogs and The stent is a woven self expanding tubular mesh of fine stainless steel wire (fìg.…”

Section: Introductionmentioning

confidence: 99%

European Experience with the Urethral Wallstent for Urethral Strictures

Ashken¹,

Coulange²,

Milroy³

et al. 1991

Eur Urol

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Section: Introductionmentioning

confidence: 99%

European Experience with the Urethral Wallstent for Urethral Strictures

Ashken¹,

Coulange²,

Milroy³

et al. 1991

Eur Urol

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“…5 Intraluminal stents have been used since 1969 to prevent stenosis after balloon angioplasty. 6,7 The use of urethral stents to prevent recurrence of urethral strictures was first reported by Miller et al, 4 and was later tried in a number of European urological units. 8,9 There has been recent enthusiasm about the use of urethral stents in the recurrent urethral strictures, giving good short-term results.…”

Section: Discussionmentioning

confidence: 99%

Role of Wallstent® in Urethral Stricture

Kardar

Lindstedt

1998

Ann Saudi Med

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Urethral stricture is still a difficult urological disease entity to cure. Commonly used methods of urethral dilatation and optical urethrotomy are associated with a significant recurrence rate.1 Urethroplasty is usually successful in the treatment of many types of urethral stricture, 2 but the results are not so encouraging in iatrogenic and postinfection strictures.3 As a more conservative approach to recurrent stricture disease, a self-expandable stainless steel stent first used in cardiovascular systems has been used successfully for strictures of the urethra. 4 We report our experience with the urethral stent in eight patients. Materials and MethodsOver a four-year period, eight men with recurrent urethral stricture disease were treated with a urethral Wallstent (Medivent SA, Lausanne, Switzerland, supplied by American Medical Systems). The clinical features of each patient are detailed in Table 1. Their age ranged from 24 to 67 years (mean = 46). All the strictures had been treated by various methods. The stricture was located in the bulbar urethra in six patients who had been treated with multiple dilatations and optical urethrotomy. One of the patients had a stricture in the supramembranous urethra, secondary to a pelvic fracture sustained in a road traffic accident. This patient had had urethroplasty twice previously. Another patient had developed detrusor-sphincter dyssynergia (DSD) as a result of cervical spinal cord injury in a road traffic accident. The length of stricture was from 1 cm to 3 cm, while the patient with DSD had a functional stricture of the whole posterior urethra. The maximum preoperative flow rate ranged from 0 mL to 8 mL per sec. (mean=3), as shown in Table 2. One of the patients with bulbar urethral stricture was passing urine in drops with no recordable flow, and the same was the case in the patient with the urethral stricture after pelvic fracture.The etiology of the strictures was infection in three cases, transurethral resection of the prostate in one, pelvic fracture in one, and DSD in one. The cause of stricture was unknown in two patients who had been having voiding problems since childhood.We used an endoscopic applicator for introduction of the stent in all cases. The length of the stent was 2 cm in two patients and 3 cm in three patients. Three patients required more than one stent overlapping each other, either because of the length of the stricture or initial placement of an undersized stent. The patients were followed at threemonth intervals. Flow rates were checked regularly, ascending urethrogram ( Figures 1A and B) and urethroscopy were performed when flow rate started to deteriorate. ResultsThe follow-up period ranged from 15 to 74 months (mean 48.1). Five patients (62.5%) were able to micturate well with satisfactory flow rates (Table 2) and without a need for further procedures. These included the patient with DSD who had been unable to empty his bladder after three internal sphincterotomies. Two patients developed recurrent stricture distal to the stent, which ...

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“…Stents with a higher concentration of metal and with greater degrees of flexibility seem to increase intimal thickness. [20][21][22] Therefore, the widespread strategy of stent implantation only if a suboptimal result is obtained after balloon angioplasty needs to be tested in a randomized trial, although we suggest that there would be a good longterm prognosis for stents aggressively implanted for a suboptimal result after balloon angioplasty.…”

Section: Bail-out Stentingmentioning

confidence: 96%