Endoscopic stenting of malignant, benign and iatrogenic colorectal disorders: a primer for radiologists

Abstract

In recent years, endoscopic placement of intraluminal stents is increasingly used to manage a widening range of colorectal disorders. Self-expanding metal stents represent an established alternative to surgery for the palliation of unresectable carcinomas and currently allow a “bridge-to-surgery” strategy to relieve large bowel obstruction and optimise the patients’ clinical conditions before elective oncologic resection. Additionally, intraluminal stents represent an appealing option to manage obstructing extracolonic tumours and selected patients with benign conditions such as refractory anastomotic strictures and post-surgical leaks. This educational paper reviews the technical features and current indications of colorectal stenting and presents the expected and abnormal radiographic, CT and MRI appearances observed during the endoscopic management of malignant, benign and iatrogenic colonic disorders with stents. The aim is to provide radiologists with a thorough familiarity with stent-related issues, which is crucial for appropriate reconstruction of focused CT images, correct interpretation of early post-procedural studies and elucidation of stent-related complications such as misplacement, haemorrhage, perforation, migration and re-obstruction.

<p>Inhibitory Effect of Curcumin on Artery Restenosis Following Carotid Endarterectomy and Its Associated Mechanism in vitro and in vivo</p>

“…Atherosclerosis, thrombosis and lumen stenosis were caused by direct suture of the carotid artery incision. [16][17][18] Cur is a plant polyphenol with a wide range of biological activities. Extensive investigations have shown that Cur exhibits antiproliferative, antimigratory, antioxidant and antiinflammatory effects.…”

Colonic stent for bridge to surgery for acute left-sided malignant colonic obstruction: A review of the literature after 2020

“…However severe adverse events only occur in < 5% of procedures[ 10 ]. Stents could be covered or uncovered, with covered stents having a lower obstruction rate[ 27 ].…”

“…SEMS can be covered and uncovered. The uncovered SEMS can be divided into through-the-scope and non-through-the-scope[ 27 ]. The through-the-scope SEMS is inserted through a guidewire.…”

“…Some early complications (within 30 d) are migration, perforation and bleeding, while some late complications (after 30 d) are a late obstruction, migration and perforation. The covered SEMS have a higher migration rate and lower obstruction rate, while uncovered SEMS have a lower migration rate[ 27 ]. Only a few studies investigated the predictors of technical failures, but it seems that a stenosis > 8 cm may be associated with a higher rate of technical failure[ 30 ].…”

EUS-guided recovery of colonic continuity after complete anastomotic stenosis with a nitinol self-expanding stent

“…Данная методика позволила сократить время пребывания больных в стационаре, процент осложнений и необходимость в наложении стомы. [4][5][6] В отличие от опухолевых, в эндоскопическом лечении доброкачественных стриктур, в частности, стриктур анастомозов, методом выбора является бужирование или баллонная дилатация. Одним из важных преимуществ последней является то, что сила, воздействующая на стриктуру, имеет исключительно центробежное направление, тогда как при бужировании сила направлена также по продольной оси.…”