运用无中心腔的支架进行胆汁引流:一项先导性研究

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:vvv_vvv
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Abstract Abstract Background: Despite several attempts to make the conventional tubular stents with a central lumen for flow less susceptible to a biofilm buildup and thereby prevent clogging, this goal has remained elusive. We hypothesized that the creation of pathways for fluid flow around the stent instead of through it would avoid this problem. The aim of our study was to report the development and the evaluation of a novel lumen-less stent. Methods: By using a software computer modeling, a 10F “ winged“ stent was designed. A pilot feasibility study was performed by using a prototype of this stent for endoscopic biliary drainage in 5 patients with malignant biliary obstruction. Observations: Modeling data revealed that the winged stent offers a larger surface area for flow, higher velocity of flow, and increased flow rates compared with the conventional tubular stent. In the clinical trial, there was a significant decrease of serum bilirubin after the placement of this stent (serum bilirubin before and 2 weeks after stent placement, 14.94 ± 5.7 mg/dL vs. 2.86 ± 1.4 p < 0.004 ), accompanied by radiologic evidence of decompression of the biliary system. Conclusions: We have shown that it is possible to provide adequate biliary drainage by using a stent without a lumen. Such a design may have potential clinical advantages over existing designs. Abstract Abstract Background: Despite several attempts to make the conventional tubular stents with a central lumen for flow less susceptible to a biofilm buildup and thereby prevent clogging, this goal has remained elusive. We hypothesized that the creation of pathways for fluid flow around the stent instead of through it would avoid this problem. The aim of our study was to report the development and the evaluation of a novel lumen-less stent. Methods: By using a software computer modeling, a 10F ”winged" stent was designed. A pilot feasibility study was performed by using a prototype of this stent for endoscopic biliary drainage in 5 patients with malignant biliary obstruction. Observations: Modeling data revealed that the winged stent offers a greater surface area for flow, higher velocity of flow, and increased flow rate In the clinical trial, there was a significant decrease of serum bilirubin after the placement of this stent (se rum bilirubin before and 2 weeks after stent placement, 14.94 ± 5.7 mg / dL vs. 2.86 ± 1.4 p <0.004), by radiologic evidence of decompression of the biliary system. Conclusions: We have shown that it is possible to provide adequate biliary drainage by using a stent without a lumen. Such a design may have potential clinical advantages over existing designs.
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