Prophylactic Paclitaxel-Eluting Stent Placement Does Not Improve Covered Femoro-Popliteal Stent Patency

AbstractGastric outlet obstruction (GOO) is a clinical consequence of any disease that produces intrinsic or extrinsic obstruction of the pyloric channel or duodenum. The most common symptoms of GOO include nausea, vomiting, abdominal pain, and weight loss. Traditionally, surgery is regarded as the standard treatment modality. However, with the development of mini-invasive technologies, fluoroscopic or endoscopic stenting and balloon dilatation have become the mainstream of the therapies. The initial recommended treatment for malignant GOO is self-expanding metal stent placement. The stent can be classified into covered and uncovered stent according to whether it is coated with a membrane. Covered stent seems to have longer stent patency, while uncovered stent has the advantage of a lower migration rate. Regarding the etiology of benign GOO, peptic ulcer disease and corrosive injury are the two main reasons. Balloon dilatation is a simple and convenient way to treat the benign GOO. Stent placement has recently been reported for the treatment of benign GOO; however, it needs further more studies to verify its effect. This article presents a concise review of current fluoroscopic or endoscopic stenting practice for malignant GOO and balloon dilatation or stenting for benign GOO.

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Maintaining Stent Patency with Radiofrequency Ablation and Interim Plastic Stent Placement for Klatskin Tumors

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-00818 ◽

2012 ◽

Vol 107 ◽

pp. S337 ◽

Cited By ~ 1

Author(s):

Niket Sonpal ◽

Patrick Saitta ◽

Gregory Haber

Keyword(s):

Radiofrequency Ablation ◽

Stent Placement ◽

Stent Patency ◽

Plastic Stent ◽

Klatskin Tumors

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Clinical outcomes in patients undergoing multiple self-expandable metallic stent placement by stent in stent technique for malignant gastric outlet obstruction.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.88 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 88-88

Author(s):

Jinwon MO ◽

Jie-Hyun Kim ◽

Seung Yong Shin ◽

Da Hyun Jung ◽

Jae Jun Park ◽

...

Keyword(s):

Gastric Outlet Obstruction ◽

Stent Placement ◽

Clinical Success ◽

Outlet Obstruction ◽

Metallic Stent ◽

Sems Placement ◽

Stent Patency ◽

Malignant Gastric Outlet Obstruction ◽

The Third ◽

Expandable Metallic Stent

88 Background: Self-expandable metallic stent (SEMS) placement is widely used for relieving the obstructive symptoms of malignant gastric outlet obstruction (MGOO). The aims were to evaluate the efficacy and safety of multiple gastroduodenal stent placement by stent in stent technique and identify predictive factors about stent patency. Methods: We retrospectively analyzed data from 170 patients with GOO receiving SEMS by stent in stent technique from July 2006 to July 2018. Among them, 90 patients had been treated with gastroduodenal SEMS placement for MGOO. Technical and clinical success rates were evaluated. And, clinical outcomes with predictors of stent patency were also analyzed. Results: Among the subjects, 34.4% were treated with secondary SEMS placement, and 9.7% were treated with third SEMS placement because of the previous stent dysfunction. The median stent patency time was 15.7 weeks (range 0-89) in the first SEMS, 10.4 weeks (range 0-44) in the second SEMS, and 11.3 weeks (range 1-29) in the third SEMS. The technical and clinical success rate were 100% and 97.8% in the first SEMS, 100% and 90.3% in the second SEMS, 100% and 100% in the third SEMS. In multivariable analysis, the first SEMS placement of covered type including Comvi stent was correlated with prolonged stent patency (OR 4.549, P = 0.001). And both chemotherapy after the first SEMS placement (OR 8.248, P = 0.006) and chemotherapy after the second SEMS placement (OR 7.467, P = 0.003) were correlated with prolonged stent patency. Serious complications such as gastrointestinal hemorrhage or perforation did not occur in any patient. Conclusions: Secondary and third gastroduodenal SEMS placement by stent in stent technique is a safe and effective treatment for the first stent dysfunction in MGOO. The stent placement of covered type and chemotherapy after stent placement is the predictor of stent patency. Keywords: Malignant gastric outlet obstruction, Self-expandable metallic stent, Stent in stent technique, Stent patency, Predictive factor

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Primary and secondary percutaneous ureteral stent placement: Comparison of stent patency and clinical outcome

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2016.12.1147 ◽

2017 ◽

Vol 28 (2) ◽

pp. S222

Author(s):

E Kim ◽

B Choi ◽

J Oh ◽

H Chun ◽

H Lee

Keyword(s):

Clinical Outcome ◽

Stent Placement ◽

Ureteral Stent ◽

Stent Patency

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Prophylactic Paclitaxel-Eluting Stent Placement does not Improve Covered Femoro-Popliteal Stent Patency

Surgery Open Science ◽

10.1016/j.sopen.2021.09.004 ◽

2021 ◽

Author(s):

Rory Marples ◽

Matthew Binks ◽

Roberto Spina ◽

Melissa Wright ◽

Ravi Huilgol

Keyword(s):

Stent Placement ◽

Stent Patency

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Treatment of Nonthrombotic Iliac Vein Lesions

Seminars in Interventional Radiology ◽

10.1055/s-0041-1727101 ◽

2021 ◽

Vol 38 (02) ◽

pp. 155-159

Author(s):

Maria Joh ◽

Kush R. Desai

Keyword(s):

Stent Placement ◽

Duplex Ultrasound ◽

Iliac Vein ◽

Venous Stasis ◽

Venous Disease ◽

Stent Patency ◽

Extrinsic Compression ◽

Low Incidence ◽

Primary Modality

AbstractNonthrombotic iliac vein lesions (NIVLs) most frequently result from extrinsic compression of various segments of the common or external iliac vein. Patients develop symptoms associated with chronic venous insufficiency (CVI); female patients may develop symptoms of pelvic venous disease. Given that iliac vein compression can be clinically silent, a thorough history and physical examination is mandatory to exclude other causes of a patient's symptoms. Venous duplex ultrasound, insufficiency examinations, and axial imaging are most commonly used to assess for the presence of a NIVL. Catheter venography and intravascular ultrasound (IVUS) are the mainstay for invasive assessment of NIVLs and planning prior to stent placement. IVUS in particular has become the primary modality by which NIVLs are evaluated; recent evidence has clarified the lesion threshold for stent placement, which is indicated in patients with moderate to severe symptoms. In appropriately selected patients, stent placement results in improved pain, swelling, quality of life, and, when present, healing of venous stasis ulcers. Stent patency is well preserved in the majority of cases, with a low incidence of clinically driven need for reintervention. In this article, we will discuss the clinical features, workup, endovascular management, and treatment outcomes of NIVL.

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A systematic review of current trends in pharmacologic management after stent placement in nonthrombotic iliac vein lesions

Phlebology The Journal of Venous Disease ◽

10.1177/02683555211052788 ◽

2022 ◽

pp. 026835552110527

Author(s):

Daniel Veyg ◽

Mustafa Alam ◽

Henry Yelkin ◽

Ruben Dovlatyan ◽

Laura DiBenedetto ◽

...

Keyword(s):

Stent Placement ◽

Iliac Vein ◽

Pharmacologic Therapy ◽

Stent Patency ◽

Pharmacologic Agent ◽

Female Ratio ◽

Current Trends ◽

Stent Retrieval ◽

Pharmacologic Management ◽

Ceap Classification

Objective Stenting of the iliac vein is increasingly recognized as a treatment for chronic venous insufficiency (CVI). However, the pharmacologic management after stent placement is unclear. This review was conducted to illustrate recent trends in anticoagulation and antiplatelet regimens following stent placement for nonthrombotic iliac vein lesions (NIVL). Methods The MEDLINE database was searched using the term “iliac vein stent.” Retrieval of articles was limited to studies conducted on humans and published in English between 2010 and 2020. Studies were included that described iliac vein stent placement. Studies were excluded that contained fewer than 25 patients, performed procedures other than stent placement, did not specify the postoperative anticoagulant used, or treated lesions of thrombotic origin. Results 12 articles were included in this review, yielding a total of 2782 patients with a male-to-female ratio of 0.77. The predominant CEAP classification encountered was C3. The most common stent used in the included studies was the Wallstent (9/12), and the most common pharmacologic regimen was 3 months of clopidogrel (6/12). Warfarin, aspirin, cilostazol, and rivaroxaban were among other agents used. Primary stent patency ranged from 63.1 to 98.3%. There was no apparent correlation between pharmacologic agent used and stent patency or subjective patient outcomes. Conclusion Multiple different approaches are being taken to pharmacologically manage patients following stent placement for NIVL. There is no consensus on which agent is best, nor is there a formal algorithmic approach for making this decision. Additionally, the findings in this study call into question whether anticoagulation following stenting for NIVL is necessary at all, given the similar outcomes among the different agents utilized. This review underscores the potential value of undertaking a multi-institutional prospective study to determine what is the best pharmacologic therapy following venous stent placement for NIVL.

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