Application of Y-shaped, coated self-expandable metallic stents for anastomotic stenosis after gastrojejunostomy (Billroth II).

BACKGROUND: Anastomotic stenosis is an infrequent but life-threatening complication after gastrojejunostomy (Billroth II). Tubular or single tubular stents have limited efficacy due to the particular anatomy. PURPOSE: To assess the feasibility of a Y-shaped, fully-coated, self-expandable, metallic stent (SEMS) for anastomotic stenosis after gastrojejunostomy (Billroth II). MATERIAL AND METHODS: Between January 2008 and August 2014, 14 patients (10 with gastric carcinoma and four with duodenal ulcers) had anastomotic stenoses following Billroth II reconstructions. Eight patients with gastric cancer had tumor recurrence near the anastomosis; two had benign strictures. The four duodenal ulcer patients had benign stenoses. An integrated Y-shaped, fully coated SEMS was designed to accord with the anatomy of residual gastrojejunal anastomotic strictures. Fourteen stents were inserted under fluoroscopic control. Follow-up was at 1, 3, 9, and 12 months, and then annually. RESULTS: All 14 stents were inserted successfully at the first attempt with a technical success rate of 100%. After stenting, abdominal symptoms resolved in all patients. All patients were followed up for 4-27 months (mean, 13.9 months). One of the eight recurrent cases died of multiple tumor metastases and liver failure after 7 months, without obstruction symptoms. In all six patients with benign anastomotic stenosis, the stents were removed successfully without complication and with no evidence of restenosis based on clinical evaluation and imaging. CONCLUSION: A Y-shaped, fully-coated SEMS proved to be a feasible and minimally invasive procedure for treating anastomotic stenosis after gastrojejunostomy (Billroth II).

Novel Copper Nanoparticles Intercalated Polyurethane Heparin/Poly-L-Lysine Chelates Coated Stents: Viability Study for Coronary Vascular Cells and Aneurysms Treatments.

Continuous delayed endothelium regeneration and continues thrombosis development designate a task for coronary artery stent rehabilitation. To progress the direct vascular cell behavior, aneurysms treatments and compatibility of cardiovascular implants novel copper intercalated polyurethane heparin/poly-L-lysine chelates treated stent has established in this report. The functional group modifications, structural characteristics, and stability of the chelates have investigated for polyurethane heparin: poly-L-lysine, copper intercalated polyurethane heparin/poly-L-lysine coated stents. The FTIR results showed the copper intercalation at 446 cmr and the Cu 2s peak at 932 eV from XPS also indicated that the successful coating of copper, polyurethane heparin, poly-L-lysine. The relative surface geomorphology of the chelates displayed the uniform Cu coating consisting of multilayer poly-L-lysine on the substrate. The stability and biocompatibility studies indicated the significantly enhanced performance with clot the APTT and TT periods as clotting and cell proliferation assessments. This type of composite proposes a stage on a stent external area for discerning track of vascular cell performance and aneurysms treatments with low side effects.