Long-term success of colonic stent insertion is influenced by indication but not by length of stent or site of obstruction

2011 ◽  
Vol 26 (2) ◽  
pp. 215-218 ◽  
Author(s):  
Christian P. Selinger ◽  
Jayapal Ramesh ◽  
Derrick F. Martin
Keyword(s):  
Stent Insertion ◽  
Colonic Stent

scholarly journals Balloon-expandable stents for treatment of symptomatic middle cerebral artery stenosis: Clinical outcomes during long-term follow-up

2018 ◽  
Vol 24 (6) ◽  
pp. 666-673 ◽  
Author(s):  
Sung Hyun Baik ◽  
Hyo Sung Kwak ◽  
Gyung Ho Chung ◽  
Seung Bae Hwang
Keyword(s):  
Middle Cerebral Artery ◽  
Clinical Outcomes ◽  
Cerebral Artery ◽  
Reperfusion Therapy ◽  
Stent Insertion ◽  
Recurrence Rates ◽  
Long Term Follow Up ◽  
Ischemic Events

Background Insertion of a balloon-expandable stent (BES) in patients with symptomatic intracranial atherosclerosis is a treatment option for reperfusion therapy. In this study, we retrospectively reviewed clinical outcomes during long-term follow-up after insertion of balloon-expandable stents in patients with symptomatic middle cerebral artery (MCA) stenosis. Methods Institutional review board approval was obtained for retrospective review of patient data. Thirty-four patients (15 men, 19 women; median age, 67.5 years) with symptomatic MCA stenosis underwent balloon-expandable stent insertion between June 2008 and December 2010. Patient records were reviewed for angiographic findings and clinical outcomes during long-term follow-up. Results Of these patients, 22 presented with acute ischemic stroke with underlying MCA atherosclerosis and had good clinical outcomes (modified Rankin Scale score (mRS): 0–2) after reperfusion therapy. Indications for stenting for the remaining 12 patients were recurrent transient ischemic attacks (TIAs) refractory to medical therapy and MCA stenosis greater than 70%. During the poststenting follow-up period, which ranged from 61 to 108 months (median, 67.5 months), a TIA occurred in five patients. Of these five patients, one experienced a complete reocclusion of the MCA stent, and three had symptomatic restenosis. The remaining 29 patients did not experience any further ischemic events or restenosis during the follow-up period. Conclusions In our study, treatment with balloon-expandable stents in patients with symptomatic MCA stenosis resulted in low recurrence rates for both ischemic events and restenosis during long-term follow-up.

Use of long term aprepitant as a treatment for refractory nausea following oesophageal stent insertion – a case report

2021 ◽  
pp. 026921632110652
Author(s):  
Richard Shoulder ◽  
Joseph Taylor ◽  
Hilary Stiel
Keyword(s):  
Symptomatic Improvement ◽  
Nausea And Vomiting ◽  
Stent Insertion ◽  
Once Daily ◽  
Routes Of Administration ◽  
Delayed Nausea ◽  
Neurokinin 1 ◽  
Oral Diet ◽  
Oesophageal Stent

Background: Aprepitant, a substance P neurokinin-1 receptor antagonist, is licenced for the prevention of acute and delayed nausea and vomiting associated with highly and moderately emetogenic cancer chemotherapy. Case: A 33 year-old male with metastatic gastro-oesophageal cancer had multiple admissions for refractory nausea and vomiting following insertion of an oesophageal stent. Action: Mechanical issues with the stent, stent removal and central causes were excluded. Multiple anti-emetic agents were trialled in combination and with varying routes of administration without significant symptomatic improvement. Formulation: A trial of aprepitant was proposed as an off-licence therapy. Outcome: One hundred sixty-five milligrammes of aprepitant was given orally every 3 days and then up titrated to once daily with significant symptomatic improvement enabling the patient to tolerate an oral diet. The patient remained stable at 12 weeks and has been accepted into two clinical trials for potential further cancer treatment. Lessons: Aprepitant can be effective in refractory nausea and vomiting outside of emetogenic chemotherapy and safely used as a chronic treatment. The prevalence of refractory nausea and vomiting as a rare adverse outcome post-oesophageal stent insertion should be studied. What now? Further research of neurokinin-1 inhibitors for indications other than chemotherapy-induced nausea and vomiting is indicated.

Acute obstructing left-sided colonic lesions: Role of preoperative endoscopic colonic stent insertion

2018 ◽  
Vol 6 (1) ◽  
pp. 17
Author(s):  
Wael Al-shelfa ◽  
MohamadS Marie ◽  
Ahmed Hashem ◽  
Shymaa Yahia ◽  
Salah Mansour ◽  
...  
Keyword(s):  
Stent Insertion ◽  
Colonic Stent

scholarly journals A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ben Warner ◽  
Phillip Harrison ◽  
Muhammad Farman ◽  
John Devlin ◽  
David Reffitt ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Liver Function Tests ◽  
Stent Insertion ◽  
Complication Rates ◽  
Metal Stent ◽  
Unique Type ◽  
Anastomotic Strictures ◽  
Stricture Recurrence

Abstract Background We report our experience of treating anastomotic strictures using a novel type of fully covered metal stent (FCSEMS). This stent, known as the Kaffes Stent, is short-length with an antimigration waist and is easily removable due to long retrieval wires deployed within the duodenum. Methods Sixty-two patients underwent ERCP and Kaffes stent insertion for post-transplant anastomotic strictures following confirmation of a stricture on MRCP. These patients were retrospectively analysed for immediate and long-term stricture resolution, improvement in symptoms and liver function tests (LFTs), stricture recurrence and complication rates. Results Of the 56 patients who had their stent removed at the time of analysis, 54 (96%) had immediate stricture resolution and 42 continued to have long-term resolution (mean follow-up period was 548 days). Of the 16 patients with symptoms of biliary obstruction, 13 had resolution of their symptoms. Overall, there was a significant improvement in LFTs after stent removal compared to before stent insertion. Complication rates were 15% with only one patient requiring biliary reconstruction. Conclusions The Kaffes stent is effective and safe at resolving post liver transplant biliary anastomotic strictures.

Rectal guiding tube to facilitate distal colonic stent insertion

2006 ◽  
Vol 50 (3) ◽  
pp. 275-277 ◽  
Author(s):  
IM Chaitowitz ◽  
KW Bell
Keyword(s):  
Stent Insertion ◽  
Colonic Stent

scholarly journals Sa1544 Risk Factors for Complications After Colonic Stent Insertion for Large Bowel Obstruction

2014 ◽  
Vol 79 (5) ◽  
pp. AB250
Author(s):  
Jensen T. Poon ◽  
Steffi Yuen ◽  
Dominic Foo ◽  
Wai-Lun Law
Keyword(s):  
Risk Factors ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Large Bowel Obstruction ◽  
Stent Insertion ◽  
Colonic Stent

scholarly journals 689 A Service Evaluation of Colonic Stent Procedures Over A 10 Year Period at University Hospital Bristol

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Y Embury-Young ◽  
F Caslake Holding ◽  
E Wates ◽  
J Shabbir
Keyword(s):  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Large Bowel ◽  
Elective Surgery ◽  
Symptom Relief ◽  
Service Evaluation ◽  
Large Bowel Obstruction ◽  
University Hospital ◽  
Stent Insertion ◽  
Colonic Stent

Abstract Introduction The National Institute of Clinical Excellence (NICE) updated guidance in January 2020 and recommend colonic stent insertion for acute left-sided bowel obstruction as either palliative treatment or a bridge to elective surgery. Colonic stent insertion has shown improved outcomes in reducing hospital stay and stoma rate when compared to emergency surgery in patients presenting with large bowel obstruction. Objectives This service evaluation aimed to identify indications, complications, and outcomes of colonic stent insertion at University Hospital Bristol(UHB). Method Retrospective analysis of all colonic stent procedures performed at UHB between 1st January 2010 to 31st May 2020. Results 87 patients had a colonic stent procedure. 60(69%) were performed as an emergency and 27(33%) electives. Obstruction was secondary to a tumour in 84(97%) patients and diverticular strictures in 3(3%). 19(22%) had stent insertion as a bridge to elective surgery. 64(74%) stents were successfully deployed. 15(75%) required emergency surgery where the stent was unsuccessful. Complications occurred in 9(14%) successfully deployed stents, including: perforation(1;1%); per-rectal bleed(1;1%); dislodgement(1:1%); bacterial translocation(1;1%); tenesmus(2;2%); more than one stent required(3;3%). 30-day mortality was 11%. Conclusions The majority of colonic stent procedures at UHB were for patients presenting with acute large bowel obstruction secondary to malignancy. Few of these patients were suitable for surgery and stent insertion primarily for symptom relief. Where stent insertion is unsuccessful there is a high conversion (75%) to emergency surgery. Complications were observed in 14% of stent procedures and 30-day mortality was 11%.

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