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Echeverry-Rendon M, Allain JP, Robledo SM, Echeverria F, Harmsen MC. Coatings for biodegradable magnesium-based supports for therapy of vascular disease: A general view. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:150-163. [DOI: 10.1016/j.msec.2019.04.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 01/22/2023]
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Xu G, Li X, He Y, Zhao H, Yang W, Xie Q. Use of Self-Expanding Metallic Ureteral Stents in the Secondary Treatment of Ureteral Stenosis Following Kidney Transplantation. J Endourol 2015; 29:1199-203. [PMID: 25879569 DOI: 10.1089/end.2015.0188] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION To evaluate the safety and efficacy of self-expanding metal stents in the treatment of ureteral stenosis following kidney transplantation. MATERIALS AND METHODS Seven patients who developed benign stenosis after kidney transplantation were treated by a self-expanding metallic stent implantation from June 2007 to March 2014. All patients had undergone at least one open surgical procedure and one endourologic procedure for treatment of the stenosis. The extent of stenosis varied from 1.2 to 3.7 cm. Ultrasonography, urography, diuretic renography, and urine culture were performed every 3 months after stent insertion. Ureteroscopic examination was performed when needed. RESULTS Stent placement was technically effective in all cases. The mean operative time was 37 minutes (range, 26-59 minutes). Lower urinary-tract symptoms and the ipsilateral flank pain were common early-stage complications and were greatly relieved after an average of 3 months. The mean follow-up duration was 38 months (range, 13-86 months), and no stent migration or fragmentation was observed. Urothelial hyperplasia occurred in only one patient and was effectively managed with a Double-J stent. Five patients had normal stable renal function; the remaining two had impaired renal function, including one patient with a preoperative renal failure who required dialysis at the end of the follow-up period (36 months). CONCLUSIONS As an alternative to open surgery, implantation of a self-expanding metal stent is a safe and effective treatment for ureteral stenosis in patients who have undergone kidney transplantation.
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Affiliation(s)
- Guibin Xu
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
| | - Xun Li
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
| | - Yongzhong He
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
| | - Haibo Zhao
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
| | - Weiqing Yang
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
| | - Qingling Xie
- 1 Department of Urology, Fifth Affiliated Hospital of Guangzhou Medical University , Guangzhou, China .,2 Center for Minimally Invasive Technique Innovation and Translation, Guangzhou Medical University , Guangzhou, China
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Liatsikos E, Kallidonis P, Stolzenburg JU, Karnabatidis D. Ureteral stents: past, present and future. Expert Rev Med Devices 2014; 6:313-24. [DOI: 10.1586/erd.09.5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Soria F, Morcillo E, Pamplona M, Uson J, Sanchez-Margallo FM. Evaluation in an Animal Model of a Hybrid Covered Metallic Ureteral Stent: A New Design. Urology 2013; 81:458-63. [DOI: 10.1016/j.urology.2012.10.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 09/25/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
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Minimally invasive treatment of ureterovaginal fistula: A review and report of a new technique. Arab J Urol 2012; 10:414-7. [PMID: 26558060 PMCID: PMC4442914 DOI: 10.1016/j.aju.2012.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 11/30/2022] Open
Abstract
Background An iatrogenic ureterovaginal fistula (UVF) can be a consequence of difficult pelvic surgery. The patient must endure a long wait before having major surgery to reconstruct the injured ureter. Reports that address the minimally invasive treatment of UVF are limited, and are reviewed here. We introduce the concept of using a Memokath™ 051 stent (PNN A/S, Hornbaek, Denmark) as a promising minimally invasive approach for UVF. Methods We used PubMed, Science Direct, Google and the Cochrane Library to assemble appropriate evidence-based reference reports. The keywords used for the search were: ‘Memokath’, ‘stent’; ‘ureterovaginal fistula’ and ‘ureteral injury’. The review showed 42 relevant articles published up to September 2011. Results Ureteric stenting consistently stopped the vaginal leak of urine. The long-term results were not encouraging after removing the JJ stents at 3 months after insertion. Most patients had a recurrence of the vaginal leak of urine. The outcome was different with the Memokath stent, that remained in situ for a duration far exceeding that of the JJ stent. The Memokath stopped the vaginal leak of urine with no episodes of urinary tract infection and no evidence of stent migration. Conclusion Long-term ureteric stenting has two advantages, in that it facilitates urine flow through the ureteric strictured segment down to the bladder, and it stops urine leakage along the fistula. It further promotes the resolution of the ureteric stricture and healing of the fistula. A duration of 3 months was inadequate when a JJ stent was used, whereas longer periods are possible with the Memokath stent. The optimum stenting period required for complete healing of a UVF remains to be defined. Long-term Memokath ureteric stenting can be an effective alternative and minimally invasive approach to conventional surgical repair in selected cases.
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Taylor ER, Benson AD, Schwartz BF. Cost Analysis of Metallic Ureteral Stents with 12 Months of Follow-Up. J Endourol 2012; 26:917-21. [DOI: 10.1089/end.2011.0481] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Eric R. Taylor
- Division of Urology, Southern Illinois University, Springfield, Illinois
| | - Aaron D. Benson
- Division of Urology, Southern Illinois University, Springfield, Illinois
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Abstract
Ureteral stents are commonly used in urology but are frequently associated with patient discomfort, stent encrustation and stent-related infection. New biomaterials, coatings and designs have been designed to attempt to reduce these problems. This article reviews coatings to reduce bacterial adhesion and encrustation. In addition, metal ureteral stents, the triclosan and ketorolac drug eluting ureteral stents, and biodegradable ureteral stents are discussed. In summary there is no perfect ureteral stent that avoids all morbidity but there have been significant advances in the last few years in stent technology.
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Affiliation(s)
- Dirk Lange
- University of British Columbia, Vancouver, BC, Canada
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Abstract
Ureteral metal stents (MSs) present a minimally invasive tool to preserve the drainage of renal pelvis whenever ureteral patency is at risk to be obstructed due to extrinsic or intrinsic etiologies. Clinical experience with these stents demonstrates that they impose a promising alternative treatment option in ureteral pathologies that are difficult to be treated via common polymeric stents. Current application of MSs in the treatment of both benign and malignant ureteral obstruction reveals quite promising results. Nevertheless, the ideal MS that would provide uncomplicated long-term effectiveness is still lucking and current MS usage is facing several adverse effects between which stent obstruction, encrustation, infection, migration, and patient discomfort. Ongoing attempts to create more inert stent with sophisticated novel designs are expected to improve current MS efficiency. MSs will play a major role in the future as a routine management of a variety of ureteral pathologies.
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Soria F, Rioja LÁ, Morcillo E, Martin C, Pamplona M, Sánchez FM. New combined approach in metallic ureteral stenting to avoid urothelial hyperplasia: study in swine model. J Urol 2011; 185:1939-45. [PMID: 21421242 DOI: 10.1016/j.juro.2010.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE We assessed the therapeutic value of a new treatment option for ureteral strictures that may avoid urothelial hyperplasia, which is the main cause of metallic stent failure. MATERIALS AND METHODS We used 24 pigs in this study. An experimental model of ureteral stricture was induced in all animals. Obstruction was confirmed by ultrasound and retrograde ureteropyelogram 6 weeks after model creation. The pigs were then randomly allocated to 2 experimental groups. Therapy involved placement of a 6 × 30 mm metallic ureteral covered stent in the ureteral stricture in group 1 and subsequent endoureterotomy at the ureteral segments adjacent to the 2 ends of the stent in group 2. A double pigtail stent was then deployed for 3 weeks. Completion studies 6 months after therapy included retrograde ureteropyelogram, endoluminal ultrasound and ureteroscopy to assess urothelial hyperplasia formation. RESULTS At the end of the study evidence of urothelial hyperplasia was seen in 50% of the pigs in group 1 and in 29% in group 2. Four and 2 cases of cranial stent migration in groups 1 and 2, respectively, were seen at 6 months. Hyperplasia and renal involvement were statistically significantly different between the groups with more damage in group 1 than in group 2. CONCLUSIONS Hyperplasia was markedly reduced when ureteral peristalsis was inhibited by endoureterotomy at the area of interaction between the stent and the ureter.
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Affiliation(s)
- Federico Soria
- Endoscopy Department, Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain.
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Liatsikos EN, Karnabatidis D, Katsanos K, Kallidonis P, Katsakiori P, Kagadis GC, Christeas N, Papathanassiou Z, Perimenis P, Siablis D. Ureteral Metal Stents: 10-Year Experience With Malignant Ureteral Obstruction Treatment. J Urol 2009; 182:2613-7. [DOI: 10.1016/j.juro.2009.08.040] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Indexed: 11/26/2022]
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