In Vivo Evaluation of the Third Generation Biodegradable Stent: A Novel Approach to Avoiding the Forgotten Stent Syndrome
In Vivo Evaluation of the Third Generation Biodegradable Stent: A Novel Approach to Avoiding the Forgotten Stent Syndrome
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DOI：
10.1016/j.juro.2012.08.202
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发表时间：
2013-02-01
影响因子：
6.6
通讯作者：
Lange, Dirk
中科院分区：
文献类型：
--
作者：
Chew, Ben H.;Paterson, Ryan F.;Lange, Dirk
目的：输尿管支架易于刺激、结垢和感染，需要额外的手术才能取出。此外，留置聚合物支架经常被遗忘，对患者造成破坏性后果。我们描述的降解时间，生理和组织学反应引起的一种新的可生物降解输尿管支架在猪model.Materials和方法：共16只雌性约克郡猪在研究中使用。10个可生物降解的Uriprene（TM）支架和6个生物稳定的Polaris（TM）支架被膀胱镜单侧插入2组动物。在不同日期进行排泄性尿路造影以及血液和尿液检查，直至第28天。在第21天取出生物稳定支架。在第28天，所有的猪进行尸检显微镜和组织学evaluation.Results：9的10个可生物降解支架（90%）完全降解4周，而1只猪有3个碎片小于1.5厘米的膀胱。排泄性尿路造影显示可生物降解支架肾的排水量相当，肾积水明显减少。两组的血液和尿液参数相似。40%植入可降解支架的猪在第7天出现血清肌酸酐短暂升高，到第10天症状消失。可降解支架组的异常组织学发现明显较少。我们评估了在一个通畅的输尿管排水特性和结果可能不代表什么发展梗阻ureters.Conclusions：第三代可生物降解支架是一种安全，有效的替代传统的聚合物支架，导致等同的排水和减少肾积水。
Purpose: Ureteral stents are prone to irritation, encrustation and infection, and they require additional procedures for removal. Furthermore, indwelling polymer stents are often forgotten with devastating consequences to the patient. We describe the degradation time, and physiological and histological responses elicited by a novel biodegradable ureteral stent in a porcine model.Materials and Methods: A total of 16 female Yorkshire pigs were used in the study. Ten biodegradable Uriprene (TM) stents and 6 biostable Polaris (TM) stents were cystoscopically inserted unilaterally in 2 groups of animals. Excretory urogram, and blood and urine tests were performed on different days until day 28. Biostable stents were removed on day 21. On day 28 all pigs underwent necropsy for microscopic and histological evaluation.Results: Nine of the 10 biodegradable stents (90%) degraded completely by 4 weeks, while 1 pig had 3 fragments smaller than 1.5 cm in the bladder. Excretory urogram showed equivalent drainage and significantly less hydronephrosis in biodegradable stented kidneys. Blood and urine parameters were similar in the 2 groups. A transient increase in serum creatinine on day 7 in 40% of the pigs with a degradable stent resolved by day 10. There were significantly fewer abnormal histological findings in the degradable stent group. We evaluated drainage characteristics in an unobstructed ureter and results may not be representative of what develops in obstructed ureters.Conclusions: The third generation biodegradable stent is a safe, effective alternative to conventional polymer stents, resulting in equivalent drainage and less hydronephrosis.