Feasibility and safety of self-expandable metal stent in nonmalignant disease of the lower gastrointestinal tract

Table 1 Stenting in diverticular disease

Ref.	Number of patients	Type of study	Single vs multicenter	Mean age (range)	Site of obstruction	Stent type	Early adverse events	Duration of stenting	Outcome
Baron et al[28], 1998	3	Prospective	Single center	63 yr (19-89)	Sigmoid colon	Wallstent1	2 migration	Not stated	3 BTS
Tamim et al[63], 2000	3	Prospective	Single center	Not stated	Sigmoid colon	Wallstent1	None	Not stated	2 BTS, 1 declined surgery
Meisner et al[64], 2004	5	Retrospective	Single center	Not stated	Sigmoid colon	Wallstent, Ultraflex1, Memotherm2	1 migration, 1 fistula	Not stated	1 Hartman after migration, 2 BTS, 1 early removal, 1 death
Suzuki et al[47], 2004	6	Retrospective	Single center	67 yr (43-91)	Sigmoid colon	Ultraflex, Wallstent1 Memotherm2	2 migration, 1 reobstruction	7.5 mo	6
Syn et al[65], 2004	3	Prospective	Single center	75.2 yr (42-92)	Sigmoid colon/ Rectum	Uncovered; Ultraflex, Wallstent1	None	3-24 d	1 unable to pass wire: Colostomy, 2 BTS
Stefanidis et al[66], 2005	1	Retrospective, case report	Single center	63	Sigmoid colon	Wallstent1	1 reobstruction	139 d	BTS but stoma
Athreya et al[67], 2006	3	Retrospective	Single center	75 yr (46-102)	Sigmoid colon	Ultraflex, Wallstent1 Memotherm2	None	Not stated	3 palliation
Jost et al[68], 2007	7	Prospective	Single center	67.3 yr (25-93)	Sigmoid colon/ Descending/Rectum	Wallstent1	1 migration, 1 reobstruction, 2 perforation	Not stated	7 BTS
Small et al[10], 2008	16	Retrospective	Single center	66 yr (41-97)	Sigmoid colon/ Descending/Rectum	Ultraflex, Wallstent1	2 perforation, 4 reobstruction	30 d	14 BTS, 2 declined surgery
Pommergaard et al[69], 2009	7	Retrospective	Single center	76.6 yr (46-97)	Sigmoid colon/left flexure	Ultraflex, Wallstent1	1 migration, 1 reobstruction, 3 perforation, 2 mortality	8 d (BTS) 91 d (palliation)	5 BTS, 2 palliation
Forshaw et al[7], 2010	3	Retrospective	Single center	67 yr (47-89)	Sigmoid colon	Wallstent1	1 migration, 1 failure to decompress	17 d (range 5-30)	2 BTS, 1 failure of stent placement
Keränen et al[9], 2010	10	Retrospective	Single center	72 yr (58-89)	Not indicated	Uncovered and covered. Ultraflex, Wallstent1	3 perforation, 1 colorectal fistula, 1 abscess	21 d	2 BTS, 5 palliation 3 emergent surgery for perforation
Arya et al[70], 2011	2	Retrospective	Single center	69.4 yr (46-85)	Sigmoid colon	Wallstent1	None	Not stated	2 BTS

¹Wallstent, Wallflex, Ultraflex, Boston Scientific;

²Memotherm, Bard, Angiomed, Karlsruhe, Germany. BTS: Bridge to surgery.

Table 2 Stenting in inflammatory bowel diseases

Ref.	Number of patients	Type of study	Single vs multicenter	Mean age (range)	Site of obstruction	Stent type	Early adverse events	Duration of stenting	Outcome
Keränen et al[9], 2010	2 (1 BTS 1 refused surgery)	Case series	Single center	41 yr (36-47)	Crohn’s anastomotic stricture	1 covered 1 uncovered; Wallstent, Ultraflex1	None	30 d (pt 1), 4 yr (pt 2)	BTS (pt 1), refused surgery, ileostomy after perforation (pt 2)
Matsuhashi et al[45], 2000	2	Case series	Single center	28 yr (27-29)	1 descending colon 1 ileo-colonic anastomosis	Covered steel Z-stent Gianturco Rosch6	1 migration	30 d (pt 1), 150 d (pt 2)	Both
Wholey et al[46], 1998	1	Case report	Single center	Not indicated	Anastomotic stricture in the descending colon	Wallstent1	None	21 d	Elective surgery 3 wk after stent placement
Suzuki et al[47], 2004	2	Case series	Single center	Not indicated	Not indicated	Wallstent, Ultraflex1, Memotherm2	1 reobstruction (pt 1)	30 d (pt 1), 90 d (pt 2)	Colostomy and stent removal in pt 2 for abscess after 3 mo
Wada et al[48], 2005	1	Case report	Single center	25 yr	Sigmoid colon	Covered metallic Gianturco Rosch6	None	32 mo	Perforation of the stent and ileosigmoid fistula: Ileostomy and resection
Bickston et al[49], 2005	1	Case report	Single center	49 yr	Terminal ileum (refractory to balloon dilation)	Wallstent1	None	60 d	Yes
Dafnis et al[50], 2007	1 (unfit for surgery)	Case report	Single center	65 yr	Recto-sigmoid junction	Uncovered; Wallstent 1	None	126 d	Second and third coaxial uncovered walls tent for ingrowth (after 126 and 267 d)
Martines et al[51], 2008	1 (BTS)	Case report	Single center	45 yr	Ileocolic anastomosis	Covered; Niti-S3	None	7 d	Scheduled surgery
Levine et al[52], 2012	5	Retrospective	Single center	49 yr (29 - 67)	4 ileocolic anastomosis 1 ileosigmoid anastomosis	Uncovered; Wallflex, Wallstent1	1 reobstruction at 3 wk	34.8 mo (4.5–109)	Yes
Attar et al[53], 2012	11	Prospective	Single center	34 yr (18-66) refractory to previous balloon dilation	8 ileocolic anastomosis 1 ileosigmoid anastomosis 2 terminal ileum	7 Hanarostent4, 4 Niti-S3	1 failure due to angulation 1 ingrowth 8 migration	15 d (1-35)	5 surgery 5 scheduled remotion of stent
Branche et al[54], 2012	7	Prospective	Single center	50 yr (36 – 59)	5 ileocolic anastomosis 2 ileosigmoid anastomosis	Partially Covered; Hanarostent 4	None	7 d	Yes
Loras et al[55], 2012	17	Retrospective	Single center	45.7 yr (21–62) refractory to previous balloon dilation	Colon and ileocolic anastomosis	4 partially covered and 21 fully covered (Hanarostent 4 and Niti-S3) (5 for stent migration, 2 stents for 1 stenosis)	1 proximal migration requiring surgery 13 spontaneous migration (11 after resolution of stenosis)	28 d (range 1–112)	Treatment was successful in 11 of 17 patients (64.7%)
Rejchrt et al[56], 2011	11	Prospective	Single center	43 yr (32–58)	2 colon, 1 ileum, 8 ileocolic anastomosis	Biodegrad-able stent; SX-ELLA5	1 failure to release, 3 spontaneous migration	4 wk for degradation	After median of 16 mo symptom free if no migration occurred
Di Mitri et al[59], 2017	1	Case report	Single center	28 yr	Sigmoid colon (UC 29 wk of pregnancy	Covered; Niti-S3	None	75 d	Removed after delivery

¹Wallstent, Wallflex, Ultraflex, Boston Scientific;

²Memotherm, Bard, Angiomed, Karlsruhe, Germany;

³Niti- S, Taewong Medical, Corea;

⁴Hanarostent, M.G. Lorenzatto, Italy;

⁵SX Ella, Ella S.C., Czech Republic;

⁶Gianturco-Rosch stent, Coo. BTS: Bridge to surgery; UC: Ulcerative colitis.