A novel, fully covered laser-cut nitinol stent with antimigration properties for nonresectable distal malignant biliary obstruction: a multicenter feasibility study.
A novel, fully covered laser-cut nitinol stent with antimigration properties for nonresectable distal malignant biliary obstruction: a multicenter feasibility study.
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DOI：
10.5009/gnl.2013.7.6.725
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发表时间：
2013-11
期刊：
影响因子：
3.4
通讯作者：
Koike K
中科院分区：
文献类型：
--
作者：
Isayama H;Kawakubo K;Nakai Y;Inoue K;Gon C;Matsubara S;Kogure H;Ito Y;Tsujino T;Mizuno S;Hamada T;Uchino R;Miyabayashi K;Yamamoto K;Sasaki T;Yamamoto N;Hirano K;Sasahira N;Tada M;Koike K
支架移位频繁发生，但覆膜自膨式金属支架（C-SEMSs）引起的并发症的预防仍未得到解决。我们前瞻性评估了一种新开发的C-SEMS，一种改良的覆膜Zeo支架（m-CZS）的抗移位作用。2010年2月至2011年1月期间，在三级转诊中心和三家附属医院，将m-CZS插入42例患者（31例初次引流病例和11例再次介入病例）。激光切割支架两端扩口1.5 cm，在距离每个扩口端1 cm处有1 cm凸起的堤岸。本研究的主要结局是支架移位率，次要结局是胆道梗阻（RBO）复发率、RBO时间、并发症频率和总生存率。在31例初次引流患者中，4例发生支架移位（12.9%，95%置信区间，5.1%-29.0%），平均时间为131天。18例（58%）发生RBO，至RBO的中位时间为107天。在既往C-SEMS移位后，10例患者中有7例（70%）未发生m-CZS移位，直至死亡。具有抗迁移特性的m-CCLs有效地（尽管不是完全地）防止了支架插入后的支架迁移。
Stent migration occurs frequently, but the prevention of complications resulting from covered self-expandable metal stents (C-SEMSs) remains unresolved. We prospectively assessed a newly developed C-SEMS, a modified covered Zeo stent (m-CZS), in terms of its antimigration effect. Between February 2010 and January 2011, an m-CZS was inserted into 42 patients (31 initial drainage cases and 11 reintervention cases) at a tertiary referral center and three affiliated hospitals. The laser-cut stent was flared for 1.5 cm at both ends, with a 1 cm raised bank located 1 cm in from each flared end. The main outcome of this study was the rate of stent migration, and secondary outcomes were the rate of recurrent biliary obstruction (RBO), the time to RBO, the frequencies of complications, and overall survival. Of the 31 patients with initial drainage, stent migration occurred in four (12.9%, 95% confidence interval, 5.1% to 29.0%), with a mean time of 131 days. RBO occurred in 18 (58%), with a median time to RBO of 107 days. Following previous C-SEMS migration, seven of 10 patients (70%) did not experience m-CZS migration until death. m-CZSs with antimigration properties effectively, although not completely, prevented stent migration after stent insertion.
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影响因子：
3
作者：
Mukai, Tsuyoshi;Yasuda, Ichiro;Moriwaki, Hisataka
通讯作者：
Moriwaki, Hisataka
影响因子：
2.9
作者：
Nakai, Yousuke;Isayama, Hiroyuki;Omata, Masao
通讯作者：
Omata, Masao
影响因子：
7.7
作者：
Saleem, Atif;Leggett, Cadman L.;Baron, Todd H.
通讯作者：
Baron, Todd H.
影响因子：
2.8
作者：
Tada, Minoru;Nakai, Yousuke;Koike, Kazuhiko
通讯作者：
Koike, Kazuhiko
影响因子：
7.7
作者：
Telford, Jennifer J.;Carr-Locke, David L.;Brugge, William R.
通讯作者：
Brugge, William R.