Futuristic Developments and Applications in Endoluminal Stenting

Abstract

Endoscopic stenting is a well-established option for the treatment of malignant obstruction, temporary management of benign strictures, and sealing transmural defects, as well as drainage of pancreatic fluid collections and biliary obstruction. In recent years, in addition to expansion in indications for endoscopic stenting, considerable strides have been made in stent technology, and several types of devices with advanced designs and materials are continuously being developed. In this review, we discuss the important developments in stent designs and novel indications for endoluminal and transluminal stenting. Our discussion specifically focuses on (i) biodegradable as well as (ii) irradiating and drug-eluting stents for esophageal, gastroduodenal, biliary, and colonic indications, (iii) endoscopic stenting in inflammatory bowel disease, and (iv) lumen-apposing metal stent.

Luminal and Extraluminal Applications of Endoscopic Stenting: A Bright Future for Gastroenterology

“…Technical description, efficacy, and safety of different techniques for drainage of pancreaticobiliary obstruction, pancreatic cyst ablation, gastric varices management, and gallbladder drainage can be found in this study. This review goes in line with previous studies, as well as the GRUPUGE guideline on EUS-guided biliary drainage [2][3][4].…”

How to Prevent and Treat the Most Frequent Adverse Events Related to Luminal Dilation and Stenting in Benign Disease

“…Stent migration can be minimized with stent fixation techniques (13), such as small-diameter OTSC that seem to significantly reduce stent migration rates when compared with no fixation, and suturing. Lumen-apposing metal stents, due to their unique design, are less prone to migration when compared with traditional stents and can also be considered for stricture lengths shorter than 10 mm, even for patients with benign pyloric or colonic strictures (14). In studies comparing different stent designs, all types of SEMS offer only modest (30%-40%) success rates of long-term dysphagia relief, with dysphagia recurrence, (severe) chest pain after stent placement, and tissue hyperplasia at the proximal end being the most commonly reported AE.…”

Best Practices in Esophageal, Gastroduodenal, and Colonic Stenting

“…A 2017 [23] and a 2021 [24] meta-analysis comparing irradiation SEMS (loaded with 125 I beads) versus traditional SEMS showed prolonged patient survival and stent patency with irradiation stents, with no differences in AE rates. Biodegradable stent (BDS) role in the palliation of malignant dysphagia is not adequately defined and should not yet be considered a valid alternative to SEMS [25].…”

“…GE Port J Gastroenterol 2023;30(suppl 1):[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] …”