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Gastrointestinal stents

Václav Hejda
Cirrhosis is the end stage of progressive development of different liver diseases and is associated with significant morbidity and mortality rates. Cirrhosis is associated with a number of potential complications, in particular with development of portal hypertension. Portal hypertension with the production of ascites, hepatic and gastric varices bleeding in the upper part of the gastrointestinal tract, presents the breakpoint in the natural course of cirrhosis, and it is associated with a considerably worse prognosis of patients, with a dramatically increased risk of mortality...
2016: Vnitr̆ní Lékar̆ství
Ido Mizrahi, Rana Eltawil, Nadav Haim, Sami A Chadi, Bo Shen, Tolga Erim, Giovanna DaSilva, Steven D Wexner
BACKGROUND: The over-the-scope clip (OTSC) is a novel endoscopic tool that enables non-surgical management of gastrointestinal (GI) defects. The aim of this study was to report our experience with OTSC for patients with GI defects. METHODS: A prospectively maintained IRB-approved institutional database was queried for all patients treated with OTSC from 2012 to 2015. Primary outcome was the clinical success of the OTSC for the individual indication. Secondary outcome was the number of additional procedures needed following OTSC...
September 29, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jibin Song, Hao Hu, Chao Jian, Kaichun Wu, Xiaoyuan Chen
Esophageal cancer is one of the six most common cancers in the world, constituting ∼7% of the gastrointestinal cancers. Esophageal stents can be inserted into the esophagus to open the pathway as a palliative treatment for advanced esophageal cancer. For the treatment of esophageal cancer, a series of anticancer drug-loaded stents such as paclitaxel or 5-fluorouracil/esophageal stent combinations have been prepared by covering a nitinol stent with a polymer or hydrogel shell. For the first time, we developed a gold nanoshell (AuNS)-coated stent with high photothermal efficiency and used in the repetitive photothermal therapy of esophageal cancer...
October 5, 2016: ACS Applied Materials & Interfaces
A Gombert, J Grommes, G Schick, M Binnebösel, C Klink, M J Jacobs, D Kotelis
OBJECTIVE: Aortoesophageal fistulas are rare and life-threatening conditions. Till now, an association between an aortoesophageal fistula and sarcoidoisis has not been reported yet. The aim of this report is to demonstrate a case of aortoesophageal fistula (AEF) secondary to sarcoidosis and its multistage interdisciplinary surgical therapy. CASE REPORT: A 66-year-old male was diagnosed with sarcoidosis in 2014. He has been treated with glucocorticoids since then and no severe health restrictions due the disease had occurred...
September 23, 2016: Annals of Vascular Surgery
Harkiran Sran, Joseph Sebastian, Samer Doughan
This case highlights the possible complications of biliary stents, which may include migration and impaction in the gastrointestinal tract. It also emphasizes the need for a robust follow-up system after stent placement, to minimize the risks and possible sequelae of a forgotten stent.
September 2016: Clinical Case Reports
Marcelo A F Ribeiro Junior, Emily Alves Barros, Sabrina Marques de Carvalho, Vinicius Pereira Nascimento, José Cruvinel Neto, Alexandre Zanchenko Fonseca
AIM: To compare the 3 main techniques of temporary closure of the abdominal cavity, vacuum assisted closure (vacuum-assisted closure therapy - VAC), Bogota bag and Barker technique, in damage control surgery. METHODS: After systematic review of the literature, 33 articles were selected to compare the efficiency of the three procedures. Criteria such as cost, infections, capacity of reconstruction of the abdominal wall, diseases associated with the technique, among others were analyzed...
August 27, 2016: World Journal of Gastrointestinal Surgery
Brittany A Potz, Thomas J Miner
Gastric outlet obstruction (GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal tract. Palliative treatment of patients' symptoms who present with GOO is an important aspect of their care. Surgical palliation of malignancy is defined as a procedure performed with the intention of relieving symptoms caused by an advanced malignancy or improving quality of life. Palliative treatment for GOO includes operative (open and laparoscopic gastrojejunostomy) and non-operative (endoscopic stenting) options...
August 27, 2016: World Journal of Gastrointestinal Surgery
Shayan Irani, Sujai Jalaj, Andrew Ross, Michael Larsen, Ian S Grimm, Todd H Baron
BACKGROUND AND AIMS: Benign gastrointestinal strictures occur typically in the esophagus and pyloric channel, but can occur anywhere in the GI tract and at anastomotic sites. Such strictures can be treated with dilation, incisional therapy, steroid injection and stents. Our aim was to describe the use of a lumen-apposing metal stent (LAMS) to treat short, benign gastrointestinal strictures. PATIENTS AND METHODS: Retrospective review of consecutive patients who underwent LAMS placement for various benign strictures at 2 tertiary care centers from August 2014 to November 2015...
September 12, 2016: Gastrointestinal Endoscopy
Manon C W Spaander, Todd H Baron, Peter D Siersema, Lorenzo Fuccio, Brigitte Schumacher, Àngels Escorsell, Juan-Carlos Garcia-Pagán, Jean-Marc Dumonceau, Massimo Conio, Antonella de Ceglie, Janusz Skowronek, Marianne Nordsmark, Thomas Seufferlein, André Van Gossum, Cesare Hassan, Alessandro Repici, Marco J Bruno
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence)...
October 2016: Endoscopy
Hussam Abou-Al-Shaar, Khaled Juan Zaza, Muhammad Anees Sharif, Samer Koussayer
Free esophageal perforation following a hybrid visceral debranching and distal endograft extension to repair a ruptured thoracoabdominal aortic aneurysm (TAAA) is a rare complication. The authors report a 56-year-old male who underwent elective thoracic endovascular aortic repair of a thoracic aneurysm. Four and a half years later, he presented with a new aneurysm extending from the distal end of the thoracic stent graft to the aortic bifurcation involving all the visceral arterial branches. The TAAA ruptured while he was awaiting an elective repair, and as a result, he underwent an emergency hybrid procedure...
October 2016: Vascular and Endovascular Surgery
Farid Jalali, Jason Samarasena, John G Lee
Endoscopists are keenly aware of bleeding risks during and immediately after cystgastrostomy and reduce this risk by endoscopic ultrasound guidance to avoid manipulation near major vessels. Bleeding risk associated with cystgastrostomy stent removal after resolution of a pancreatic fluid collection, however, is less evident. We present our experience with bleeding during cystgastrostomy stent removal in a patient with resolved walled-off necrosis and will discuss the significance of unexplained spontaneous upper gastrointestinal bleeding in this setting, which may serve as a warning sign for possible stent erosion into major vessels...
July 2016: ACG Case Reports Journal
Jayaprakash Sreenarasimhaiah
In the last decade, the treatment of dysplastic Barrett's esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barrett's esophagus. One of the newest therapies, cryospray ablation, has become a modality to treat both dysplastic Barrett's esophagus as well as esophageal carcinoma. In endoscopic applications, the cryogen used is either liquid nitrogen or carbon dioxide which causes tissue destruction through rapid freeze-thaw cycles...
August 25, 2016: World Journal of Gastrointestinal Endoscopy
Massimiliano Mutignani, Lorenzo Dioscoridi, Stefanos Dokas, Paolo Aseni, Pietro Carnevali, Edoardo Forti, Raffaele Manta, Mariano Sica, Alberto Tringali, Francesco Pugliese
Between April 2013 and October 2015, 6 patients developed periampullary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam...
August 10, 2016: World Journal of Gastrointestinal Endoscopy
Christian McNeely, Stephen Markwell, Christina M Vassileva
BACKGROUND: Since year 2000, reducing hospital readmissions has become a public health priority. In addition, there have been major changes in percutaneous coronary intervention (PCI) during this period. METHODS: The cohort consisted of 3,250,194 patients admitted for PCI from January 2000 through November 2012. RESULTS: Overall, 30-day readmission was 15.8%. Readmission rates declined from 16.1% in 2000 to 15.4% in 2012 (adjusted odds ratio for readmission 1...
September 2016: American Heart Journal
Guillaume Bonnet, Erwan Salaun, Mathieu Pankert, Thomas Cuisset, Jean-Louis Bonnet
BACKGROUND: Left atrial appendage (LAA) closure using the WATCHMAN™ device (WM) may be considered in patients with non-valvular atrial fibrillation (AF) and a high-risk of stroke who are ineligible for long-term oral anticoagulation (OAC). AIM: To report our single-centre preliminary experience, focusing on feasibility, safety and short-term efficacy of this procedure. METHODS: Patients implanted from December 2013 to February 2014 were included...
September 1, 2016: Archives of Cardiovascular Diseases
Norihiro Kobayashi, Masahiro Yamawaki, Masatsugu Nakano, Keisuke Hirano, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Yoshiaki Ito
BACKGROUND: No scoring system for evaluating the bleeding risk of atrial fibrillation (AF) patients after drug-eluting stent (DES) implantation with triple antithrombotic therapy (TAT) is available. We aimed to develop a new scoring system for predicting bleeding complications in AF patients after DES implantation with TAT. METHODS AND RESULTS: Between April 2007 and April 2014, 227 AF patients undergoing DES implantation with TAT were enrolled. Bleeding incidence defined as Bleeding Academic Research Consortium criteria≥2 was investigated and predictors of bleeding complications were evaluated using multivariate analysis...
November 15, 2016: International Journal of Cardiology
Seung Koo Yang, Chang Jin Yoon
Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach...
September 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Nikos Papageorgiou, Alexandros Briasoulis, George Lazaros, Massimo Imazio, Dimitris Tousoulis
AIMS: Colchicine has been suggested to be beneficial in preventing recurrent pericarditis. The goal of this study was to review all randomized controlled trials that assess the use of colchicine for the prevention and treatment of cardiac diseases. METHODS: We performed a meta-analysis of the effects of colchicine on pericarditis, post-pericardiotomy syndrome and post-procedural atrial fibrillation recurrence, in-stent restenosis, gastrointestinal adverse effects and treatment discontinuation rates...
August 31, 2016: Cardiovascular Therapeutics
Haibo Jia, Jiannan Dai, Jingbo Hou, Lei Xing, Lijia Ma, Huimin Liu, Maoen Xu, Yuan Yao, Sining Hu, Erika Yamamoto, Hang Lee, Shaosong Zhang, Bo Yu, Ik-Kyung Jang
AIMS: Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. METHODS AND RESULTS: This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled...
August 30, 2016: European Heart Journal
Nobuyoshi Takeshita, Khek Yu Ho
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects...
September 2016: Clinical Endoscopy
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