Oesophagus stents

Thermoanalytical techniques have had a major application in the understanding of transitions in the skin and of drug penetration of the skin. The application of thermoanalytical techniques to prosthetics and implants is also discussed, as are recent DSC investigations of the oesophagus that provided the information on thermal stability required for successful stent implantation. The use of thermoanalytical techniques such as modulated temperature differential scanning calorimetry (MTDSC) has been be used to characterise polymeric material in order to determine whether there are interactions with drug substances to control and predict drug delivery. 

Figure 11. Thermal profiles of stents 1 and 2 (oesophagus muscle). (Adapted from [30]).

As illustrated in Table 2, the DSC results show that the stent 1 has improved the thermal stability of the oesophagus and has assisted in its regeneration. This may be an effective intervention for oesophageal bleeding patients suffering from cirrhosis until endoscopic band ligation can be accomplished. Stent treatment has thus improved the thermal stability of the oesophagus. 

Insertion of self-expanding metallic stents is now a well-established method to treat obstructions of the biliary tract (Rossi et al. 1994) and the oesophagus (Song et al. 1994 Adam et al. 1997). Recently their use has been extended to gastroduodenal outlet obstruction and treatment of acute ileus in colorectal obstruction. Patients with malignant gastroduodenal as well as colorectal obstruction are often elderly,... 

Fig. 3.18a-c. Malignant stricture of the mid-oesophagus with irregular margins (a). Dilatation with a hydraulic balloon (b), and permanently treated with an expandable metal stent to keep the lumen patent (c)... 

Recurrent dysphagia in the early stages following stent placement is usually due to stent displacement which occurs in around 5% of stents placed in the oesophagus proper and around 15% in stents placed across the cardia (BSIR 2004). It is generally wise to remove a displaced stent before re-stenting. 

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