Transpapillary stents are increasingly being used for biliary strictures, whether benign or malignant. However, there are different stent types and available data is controversial. Recently, completely covered self-expandable metal stents (CSEMSs) have been proposed as an alternative therapeutic option in different biliary indications, including strictures of the distal bile duct, anastomotic stenosis after orthotopic liver transplantation, bile duct leaks, periampullary perforation following endoscopic sphincterotomy (ES), and postsphincterotomy bleeding. Despite the higher costs of these devices, fully covered self-expanding metal stents seem to be a suitable therapeutic option to relief biliary obstruction due to bile duct stenosis, regardless of the underlying cause.
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http://dx.doi.org/10.1155/2012/498617 | DOI Listing |
Nagoya J Med Sci
November 2024
School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Intracardiac migration of inferior vena cava (IVC) filter or stent is a rare but potentially fatal complication of endovascular venous device placement. There is no consensus whether migrated stents should be surgically removed by open cardiac surgery or retrieved by the percutaneous endovascular route and whether an intervention should be performed immediately or expectantly. Herein, we report a 39-year-old female who received emergent left lobe living donor liver transplantation (LDLT) owing to posthepatectomy liver failure.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Department of Gastroenterology and Hepatology, Campus Virchow/Campus Mitte, Charité Berlin, Berlin 10117, Germany.
Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions. However, its use in complex biliary obstructions is limited. Over the past decades, therapeutic endosonography (EUS) and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring non-endoscopic or surgical approaches.
View Article and Find Full Text PDFNeuroradiol J
January 2025
Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, USA.
Flow diversion is a transformative approach in neurointerventional surgery for intracranial aneurysms that relies heavily on effective antiplatelet therapy. The ideal approach, including the timing of treatment, the use of dual antiplatelet therapy (DAPT), and the number of flow-diverter devices to use, remains unknown. DAPT, which combines aspirin with a thienopyridine like clopidogrel, prasugrel, or ticagrelor, is the standard regimen, balancing thromboembolic protection and hemorrhagic risk.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Pre-Clinical Research Centre, Wrocław Medical University, Marcinkowskiego 1, 50-368 Wrocław, Poland.
Percutaneous Coronary Intervention (PCI) is a treatment method that involves reopening narrowed arteries with a balloon catheter that delivers a cylindrical, mesh-shaped implant device to the site of the stenosis. Currently, by applying a coating to a bare metal stent (BMS) surface to improve biocompatibility, the main risks after PCI, such as restenosis and thrombosis, are reduced while maintaining the basic requirements for the mechanical behavior of the stent itself. In this work, for the first time, the development and optimization process of the spatial structure of the Co-Cr stent (L-605) with a graphene-based coating using cold-wall chemical vapor deposition (CW-CVD) to ensure uniform coverage of the implant was attempted.
View Article and Find Full Text PDFJ Clin Med
December 2024
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.
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