Anchoring fins of fully covered self-expandable metal stents affect pull-out force and stent migration

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Background and Aims: Stent migration and subsequent adverse events are frequently observed in the use of fully covered self-expandable metal stents (FCSEMSs) for distal biliary stenosis. In this study, we identified predictors for stent migration based on biomechanical stent characteristics and associated these findings with clinical outcomes. Methods: The migration resistance of FCSEMSs was quantified by measuring the pull-out force. We analyzed a single-center retrospective cohort of 178 FCSEMSs for treatment success and adverse events occurring during 180 days of follow-up. Results: Biomechanical measurements revealed a 4-fold higher migration resistance of FCSEMSs with anchoring fins (AF-FCSEMSs; F max = 14.2 ± .1 N) compared with FCSEMSs with flared ends (FE-FCSEMSs; F max = 3.8 ± 1.0 N; P < .0001). Clinically, AF-FCSEMSs showed lower rates of migration compared with FE-FCSEMSs (5% vs 34%, P < .0001). Unscheduled ERCP procedures because of stent dysfunction were less frequent in the AF group compared with the FE group (15% vs 29%, P = .046). Cholangitis because of stent dysfunction was observed in 5% of the AF group compared with 19% in the FE group (P = .02). Stent patency rates at 1, 3, and 6 months were higher in the AF group (96%, 90%, and 80%, respectively) compared with the FE group (90%, 74%, and 66%; log-rank test: P = .03). Conclusions: The pull-out force as a biomechanical stent property predicts the migration resistance of FCSEMSs in distal biliary stenosis and may thus be used to classify stents for this application. AF-FCSEMSs showed a significantly lower rate of migration and adverse events compared with FE-FCSEMSs.

Details

Original languageEnglish
Pages (from-to)377 - 386.e3
JournalGastrointestinal endoscopy
Volume99
Issue number3
Early online date18 Oct 2023
Publication statusPublished - Mar 2024
Peer-reviewedYes

External IDs

unpaywall 10.1016/j.gie.2023.10.036
Scopus 85185392650
Mendeley 27339b80-1aef-3e21-a7f8-55b3df30f2ae

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