Anchoring fins of fully covered self-expandable metal stents affect pull-out force and stent migration.
Gastrointest Endosc
; 99(3): 377-386.e3, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37863243
ABSTRACT
BACKGROUND AND AIMS:
Stent migration and subsequent adverse events are frequently observed in the use of fully covered self-expandable metal stents (FCSEMSs) for distal biliary stenosis. In this study, we identified predictors for stent migration based on biomechanical stent characteristics and associated these findings with clinical outcomes.METHODS:
The migration resistance of FCSEMSs was quantified by measuring the pull-out force. We analyzed a single-center retrospective cohort of 178 FCSEMSs for treatment success and adverse events occurring during 180 days of follow-up.RESULTS:
Biomechanical measurements revealed a 4-fold higher migration resistance of FCSEMSs with anchoring fins (AF-FCSEMSs; Fmax = 14.2 ± .1 N) compared with FCSEMSs with flared ends (FE-FCSEMSs; Fmax = 3.8 ± 1.0 N; P < .0001). Clinically, AF-FCSEMSs showed lower rates of migration compared with FE-FCSEMSs (5% vs 34%, P < .0001). Unscheduled ERCP procedures because of stent dysfunction were less frequent in the AF group compared with the FE group (15% vs 29%, P = .046). Cholangitis because of stent dysfunction was observed in 5% of the AF group compared with 19% in the FE group (P = .02). Stent patency rates at 1, 3, and 6 months were higher in the AF group (96%, 90%, and 80%, respectively) compared with the FE group (90%, 74%, and 66%; log-rank test P = .03).CONCLUSIONS:
The pull-out force as a biomechanical stent property predicts the migration resistance of FCSEMSs in distal biliary stenosis and may thus be used to classify stents for this application. AF-FCSEMSs showed a significantly lower rate of migration and adverse events compared with FE-FCSEMSs.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Colestase
/
Stents Metálicos Autoexpansíveis
Limite:
Humans
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Alemanha