Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Kadokura M, Takenaka Y, Yoda H, Yasumura T, Okuwaki T, Tanaka K, Amemiya F. Fracture of a Self-expandable Metallic Stent Inserted for Malignant Gastric Outlet Obstruction. Intern Med 2021;60:1525-1528. [PMID: 33250468 PMCID: PMC8188040 DOI: 10.2169/internalmedicine.6216-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open

For:	Kadokura M, Takenaka Y, Yoda H, Yasumura T, Okuwaki T, Tanaka K, Amemiya F. Fracture of a Self-expandable Metallic Stent Inserted for Malignant Gastric Outlet Obstruction. Intern Med 2021;60:1525-1528. [PMID: 33250468 PMCID: PMC8188040 DOI: 10.2169/internalmedicine.6216-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open

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Cited by Other Article(s)

Fujikawa H, Saigusa S, Aono Y, Ikeda M, Tempaku N, Hashimoto K, Mohri T, Sakurai H, Inoue Y, Tanaka K. Small Bowel Obstruction Caused by Migration of Fractured Metal Stent in Patients with Malignant Gastric Outlet Obstruction: A Report of Two Cases and Review of the Literature. Intern Med 2024;63:1873-1878. [PMID: 38008457 PMCID: PMC11272498 DOI: 10.2169/internalmedicine.2058-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/18/2023] [Indexed: 11/28/2023] Open

Abboud Y, El Helou MO, Meza J, Samaan JS, Bancila L, Randhawa N, Park KH, Mehdizadeh S, Gaddam S, Lo SK. Esophageal Self-Expandable Metal Stents Can Fracture in the Distal Third When Used for Post-Bariatric Surgery Complications: A Single Center Experience and Review of the Literature with Video. J Clin Med 2024;13:3419. [PMID: 38929948 PMCID: PMC11204956 DOI: 10.3390/jcm13123419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open

Abstract

Background: Esophageal self-expandable metal stents (SEMS) are an important endoscopic tool. These stents have now been adapted successfully to manage post-bariatric surgery complications such as anastomotic leaks and strictures. In centers of expertise, this has become the primary standard-of-care treatment given its minimally invasive nature, and that it results in early oral feeding, decreased hospitalization, and overall favorable outcomes. Self-expandable metal stents (SEMS) fractures are a rare complication of unknown etiology. We aimed to investigate possible causes of SEMS fractures and highlight a unique endoscopic approach utilized to manage a fractured and impaled SEMS. Methods: This is a retrospective study of consecutive patients who underwent esophageal SEMS placement between 2015-2021 at a tertiary referral center to identify fractured SEMS. Patient demographics, stent characteristics, and possible etiologies of fractured SEMS were identified. A comprehensive literature review was also conducted to evaluate all prior cases of fractured SEMS and to hypothesize fracture theories. Results: There were seven fractured esophageal SEMS, of which six were used to manage post-bariatric surgery complications. Five SEMS were deployed with their distal ends in the gastric antrum and proximal ends in the distal esophagus. All stents fractured within 9 weeks of deployment. Most stents (5/7) were at least 10 cm in length with fractures commonly occurring in the distal third of the stents (6/7). The wires of a fractured SEMS were embedded within the esophagogastric junction in one case, prompting the use of an overtube that was synchronously advanced while steadily extracting the stent. Discussion: We suggest the following four etiologies of SEMS fractures: anatomical, physiological, mechanical, and chemical. Stent curvature at the stomach incisura can lead to strain- and stress-related fatigue due to mechanical bending with exacerbation from respiratory movements. Physiologic factors (gastric body contractions) can result in repetitive squeezing of the stent, adding to metal fatigue. Intrinsic properties (long length and low axial force) may be contributing factors. Lastly, the stomach acidic environment may cause nitinol-induced chemical weakness. Despite the aforementioned theories, SEMS fracture etiology remains unclear. Until more data become available, it may be advisable to remove these stents within 6 weeks.

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Affiliation(s)

Yazan Abboud Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.) Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
Mohamad Othman El Helou Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.) Department of General Surgery, Yale University, New Haven, CT 06510, USA
Joseph Meza Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Jamil S. Samaan Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Liliana Bancila Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Navkiran Randhawa Division of Gastroenterology and Hepatology, Augusta University, Augusta, GA 30912, USA;
Kenneth H. Park Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Shahab Mehdizadeh Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Srinivas Gaddam Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)
Simon K. Lo Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (M.O.E.H.); (J.M.); (J.S.S.); (L.B.); (K.H.P.); (S.M.); (S.G.)

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Ozawa M, Arai Y, Sone M, Sugawara S, Itou C, Kimura S, Omori J, Koretsune Y. Jejunal Obstruction Due to Fractured Duodenal Stent: Percutaneous Recovering with Additional Stent Placement. Cardiovasc Intervent Radiol 2022;45:1408-1410. [PMID: 35551443 DOI: 10.1007/s00270-022-03156-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]