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( Hiroyuki Isayama ),( Kazumichi Kawakubo ),( Yousuke Nakai ),( Kouta Inoue ),( Chimyon Gon ),( Saburo Matsubara ),( Hirofumi Kogure ),( Yukiko Ito ),( Takeshi Tsujino ),( Suguru Mizuno ),( Tsuyoshi H The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6
Background/Aims: 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 modi-fied covered Zeo stent (m-CZS), in terms of its antimigration effect. Methods: 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 second-ary outcomes were the rate of recurrent biliary obstruction (RBO), the time to RBO, the frequencies of complications, and overall survival. Results: Of the 31 patients with initial drainage, stent migration occurred in four (12.9%, 95% con-fidence 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. Conclusions: m-CZSs with antimigration properties ef-fectively, although not completely, prevented stent migration after stent insertion. (Gut Liver 2013;7:725-730)
Wataru Yamagata,Toshio Fujisawa,Takashi Sasaki,Rei Ishibashi,Tomotaka Saito,Shuntaro Yoshida,Shizuka No,Kouta Inoue,Yousuke Nakai,Naoki Sasahira,Hiroyuki Isayama 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.5
Background/Aims: Mechanical properties (MPs) and axial and radial force (AF and RF) may influence the efficacy and complicationsof self-expandable metallic stent (SEMS) placement. We measured the MPs of various SEMSs and examined their influence on theSEMS clinical ability. Methods: We evaluated the MPs of 29 types of 10-mm SEMSs. RF was measured using a conventional measurement device. AF wasmeasured using the conventional and new methods, and the correlation between the methods was evaluated. Results: A high correlation in AFs was observed, as measured by the new and conventional manual methods. AF and RF scatterplotsdivided the SEMSs into three subgroups according to structure: hook-and-cross-type (low AF and RF), cross-type (high AF and lowRF), and laser-cut-type (intermediate AF and high RF). The hook-and-cross-type had the largest axial force zero border (>20°), followedby the laser-cut and cross types. Conclusions: MPs were related to stent structure. Hook-and-cross-type SEMSs had a low AF and high axial force zero border and wereconsidered safest because they caused minimal stress on the biliary wall. However, the increase in RF must be overcome.