Efficacy and safety of endoscopic laser lithotripsy and lithotomy through the lumen-apposing metal stent for giant gallbladder stones

We present the case of treatment of choledocholithiasis complicated with obstructive jaundice and acute grade II cholangitis according to Tokyo criteria in the female patient aged 96 years with significant comorbidity. Peroral digital cholangioscopy and laser contact lithotripsy were made. No complications were observed in postoperative period, and the manifestations of cholangitis and obstructive jaundice regressed. In our opinion, high efficacy and safety of the used method are the strong argument for the use in patients with difficult choledocholithiasis who have significant comorbidities during the single-stage endoscopic operation.

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Endoscopic laser lithotripsy and lithotomy through the lumen-apposing metal stent for a giant gallstone after EUS gallbladder drainage

VideoGIE ◽

10.1016/j.vgie.2017.01.015 ◽

2017 ◽

Vol 2 (5) ◽

pp. 112-115 ◽

Cited By ~ 2

Author(s):

Wei Wang ◽

Xingang Shi ◽

Zhendong Jin ◽

Zhaoshen Li

Keyword(s):

Laser Lithotripsy ◽

Metal Stent ◽

Gallbladder Drainage ◽

Endoscopic Laser

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Abstract 16775: Efficacy and Safety of a Thinner-strut Silicon Carbide-coated Cobalt Chromium Bare-metal Stent Compared to a Thin-strut Uncoated Cobalt Chromium Bare-metal Stent in Large Vessel Stenting: Insights From Two Prospective Randomised All-comers Trials

Circulation ◽

10.1161/circ.132.suppl_3.16775 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Kim W Hansen ◽

Rikke Sørensen ◽

Raban Jeger ◽

Christoph Kaiser ◽

Matthias Pfisterer ◽

...

Keyword(s):

Silicon Carbide ◽

Cardiac Death ◽

Bare Metal Stent ◽

Bare Metal ◽

Target Vessel ◽

Efficacy And Safety ◽

Cobalt Chromium ◽

Metal Stent ◽

Target Vessel Revascularization ◽

New Generation

Introduction: The new generation thinner-strut silicon carbide (SiC) coated cobalt chromium (CoCr) bare-metal stents (BMS) are designed to accelerate rapid endothelialisation and reduce thrombogenicity when implanted in coronary arteries. However, smaller studies suggest reduced efficacy with higher rates of symptomatic restenosis in patients receiving the newer generation BMS. Objective: We investigated the efficacy and safety of a new generation thinner-strut SiC coated CoCr BMS (SCC-BMS) as compared to an older thin-strut uncoated CoCr BMS (UC-BMS) in patients presenting with coronary artery disease requiring stenting of large vessels (≥3.0mm) and thus at low risk of restenosis. Methods: We included all patients randomized to SCC- (n=761) or UC-BMS (n=765) in the BASKET-PROVE II and I trials, respectively. Design, patients, interventions and follow-up were similar between trials except differing regimens of dual antiplatelet therapy. The primary endpoint was clinically driven target-vessel revascularization within 24 months. Safety endpoints of cardiac death, non-fatal myocardial infarction (MI), and definite/probable stent thrombosis were also assessed. We used Cox proportional hazards regressions to estimate relative hazards adjusting for known confounders. Results: Demographics, clinical presentation, and risk factors were comparable between the groups, but patients receiving SCC-BMS underwent less complex procedures. Rates of the primary endpoint were 10.4% in the SCC-BMS group and 8.4% among patients receiving UC-BMS yielding an adjusted relative hazard (HR) of 1.46 ([1.03-2.07], p=0.032). Estimates for the safety endpoints were: cardiac death (1.8% vs. 2.4% ; HR 0.77 [0.36-1.59], p=0.46), non-fatal MI (3.2% vs. 2.5% ; HR 1.68 [0.88-3.21], p=0.11), and definite/probable stent thrombosis (0.8% vs. 1.0% ; HR 0.97 [0.32-3.00], p=0.96). We detected no particular subgroups driving the increased risk of target-vessel revascularization in the SCC-BMS group. Conclusions: In patients requiring stenting of large coronary arteries, use of the newer generation SCC-BMS was associated with a higher risk of symptomatic restenosis despite less complex procedures compared to the UC-BMS with no signs of an offsetting safety benefit.

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Efficacy and safety of laser lithotripsy in fragmentation of urocystoliths and urethroliths for removal in dogs

Journal of the American Veterinary Medical Association ◽

10.2460/javma.234.10.1279 ◽

2009 ◽

Vol 234 (10) ◽

pp. 1279-1285 ◽

Cited By ~ 25

Author(s):

Jody P. Lulich ◽

Carl A. Osborne ◽

Hasan Albasan ◽

Manoj Monga ◽

John M. Bevan

Keyword(s):

Laser Lithotripsy ◽

Efficacy And Safety

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Mid-term Efficacy and Safety of Drug-coated Balloon versus Nitinol Bare Metal Stent for Primary Lesions in Femoropopliteal Artery Disease

Annals of Vascular Surgery ◽

10.1016/j.avsg.2021.09.022 ◽

2021 ◽

Author(s):

Haocheng Ma ◽

Xuemin Zhang ◽

Jing Li ◽

Qingle Li ◽

Wei Li ◽

...

Keyword(s):

Bare Metal Stent ◽

Bare Metal ◽

Efficacy And Safety ◽

Metal Stent ◽

Femoropopliteal Artery ◽

Term Efficacy ◽

Artery Disease ◽

Drug Coated Balloon

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Efficacy and safety of peroral cholangioscopy with intraductal lithotripsy for difficult biliary stones: a systematic review and meta-analysis

Endoscopy ◽

10.1055/a-1200-8064 ◽

2020 ◽

Author(s):

Thomas R. McCarty ◽

Rishabh Gulati ◽

Tarun Rustagi

Keyword(s):

Adverse Events ◽

Meta Analysis ◽

Laser Lithotripsy ◽

Efficacy And Safety ◽

Procedure Time ◽

Single Session ◽

Biliary Stones ◽

Peroral Cholangioscopy ◽

Stone Fragmentation ◽

Fragmentation Rate

Abstract Background Peroral cholangioscopy with intraductal lithotripsy facilitates optically guided stone fragmentation of difficult biliary stones refractory to conventional endoscopic therapy. The aim of this study was to evaluate the efficacy and safety of peroral cholangioscopy with intraductal lithotripsy for difficult biliary stones. Methods Searches of PubMed, EMBASE, Web of Science, and Cochrane databases were performed in accordance with PRISMA and MOOSE guidelines. Measured outcomes included overall fragmentation success, single-session fragmentation and duct clearance, and rate of adverse events. Sensitivity and subgroup analyses were performed based upon cholangioscopy technique and type of lithotripsy (laser versus electrohydraulic). Heterogeneity was assessed with I 2 statistics. Publication bias was ascertained by funnel plot and Egger regression testing. Results 35 studies were included with 1762 participants (43.4 % men; mean age 61.5 [standard deviation (SD) 11.0]). Prior cholecystectomy had been performed in 37 % of patients, with a mean number of 1.6 (SD 0.5) ERCPs performed prior to lithotripsy. Mean stone size was 1.8 (SD 0.3) cm. Peroral cholangioscopy with intraductal lithotripsy achieved an overall stone fragmentation success of 91.2 % (95 %CI 88.1 % – 93.6 %; I 2 = 63.2 %) with an average of 1.3 [SD 0.6] lithotripsy sessions performed. Complete single-session fragmentation success was 76.9 % (95 %CI 71.6 % – 81.4 %; I 2 = 74.3 %). The adverse events rate was 8.9 % (95 %CI 6.5 % – 12.2 %; I 2 = 60.6 %). Mean procedure time for peroral cholangioscopy was 67.1 (SD 21.4) minutes. There was no difference in overall fragmentation rate or adverse events; however, laser lithotripsy was associated with a higher single-session fragmentation rate and shorter procedure time compared with electrohydraulic lithotripsy. Conclusions Peroral cholangioscopy with intraductal lithotripsy appears to be a relatively safe and effective modality for difficult biliary stones.

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