Stent occlusion

De Ledinghen V, Person B, Legoux JL et al (2000) Prevention of biliary stent occlusion by ursodeoxycholic acid plus norfloxacin a multicenter randomized trial. Dig Dis Sci 45 145-150... 

Funaki B, Zaleski GX, Straus CA, Leef JA, Funaki AN, Lorenz J, Farrell TA, Rosenblum JD (2000) Percutaneous biliary drainage in patients with non-dilated intrahepatic bile ducts. AJR Am J Roentgenol 175 268 Gabelmann A, Hamid H, Brambs HJ et al (2001) Metallic stents in benign biliary strictures long-term effectiveness and interventional management of stent occlusion. AJR Am J Roentgenol 177 813 17... 

Ghosh S, Palmer KR (1994) Prevention of biliary stent occlusion using cyclical antibiotics and ursodeoxycholic acid. Gut 35 1757-1759... 

Treatment of stent occlusion includes local thrombolysis, thrombectomy, balloon dilatation and placement of additional stents. The possible causes of occlusion are intraluminal tumor growth, or tumor growth at the free ends of the stent as a consequence of insufficient coverage of the strictures by the stent, vessel contraction, and inadequate stent diameter leading to distal stent migration (Figs. 5.11, 5.12). 

Ong, A. T. L., Hoye, A., Aoki, J., et al. (2005) Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation, J. Am. Coll. Cardiol., 45, 947-53. 

Regar, E., Lemos, P. A., Saia, F., et al. (2004) Incidence of thrombotic stent occlusion during the first three months after sirolimus-eluting stent implantation in 500 consecutive patients, Am. J. Cardiol, 93, p. 1271. 

Any reported complication resulting from nephrostomy insertion such as bleeding, sepsis, or urine extravasation secondary to a leak or laceration may also be noted after a percutaneous surgical procedure. Complications specific to percutaneous stricture dilatation include ureteral perforation or rupture and intraluminal or submucosal hematoma. Surprisingly, these problems have rarely been reported in either adults or children. Untoward effects related to stent placement are more common, but still unusual in the pediatric population (WooDSiDE et al. 1985). Stent occlusion is probably most common and occurs secondary to encrus-... 

Stenting of an acutely occluded intracranial vessel may provide fast recanalization by entrapping the thrombus between the stent and the vessel wall. A recent study in which 19 patients with acute occlusions at the ICA terminus n = 8), M1/M2 (n = 7), or basilar artery (n = 4) were treated with balloon-expandable stents showed a TIMI 2 and 3 recanalization rate of 79% and no symptomatic intracranial hemorrhages (Fig. 4.5). ... 

Self-expanding stents with a higher radial force (e.g., WingSpan, Boston Scientific Corp.) will probably play a key role in acute stroke cases related to intracranial atherosclerotic disease. Antegrade flow is essential for the maintenance of vascular patency, as particularly evident in patients with severe proximal stenoses who commonly develop rethrombosis after vessel recanalization. Furthermore, stenting of the proximal vessels may be required in order to gain access to the intracranial thrombus with other mechanical devices or catheters. In a recent series, 23 of 25 patients (92%) with acute n = 15) or subacute n = 10) ICA occlusions were successfully revascularized with this technique. " ... 

Levy El, Sauvageau E, Hanel RA, Parikh R, Hopkins LN. Self-expanding versus balloon-mounted stents for vessel recanalization following embolic occlusion in the canine model technical feasibility study. Am J Neuroradiol 2006 27 2069-2072. 

Jovin TG, Gupta R, Uchino K, Jungreis CA, Wechsler LR, Hammer MD, Tayal A, Horowitz MB. Emergent stenting of extracranial internal carotid artery occlusion in acute stroke has a high revascularization rate. Stroke 2005 36 2426-2430. 

Two-vessel coronary artery disease (60% right coronary artery [RCA] and 80% left anterior descending artery [LAD] occlusion) after intracoronary CYPHER stent placement to the mid-LAD artery lesion 10 months ago. 

The paradigm shift in 1980 on the causation of acute myocardial infarction to acute coronary occlusion by a thrombus created the rationale for thrombolytic therapy of this common lethal disease. At that time—and for the first time-intravenous thrombolytic therapy for acute myocardial infarction in the European Cooperative Study Group trial was found to reduce mortality significantly. Later studies, with thousands of patients in each trial, provided enough statistical power for the 20% reduction in mortality to be considered statistically significant. Although the standard of care in areas with adequate facilities and experience in percutaneous coronary intervention (PCI) now favors catheterization and placement of a stent, thrombolytic therapy is still very important where PCI is not readily available. 

To provide optimal immunosuppressant effects, sirolimus is typically combined with glucocorticoids or other immunosuppressants. Sirolimus exerts a number of other beneficial effects, including the ability to inhibit smooth muscle proliferation in blood vessel walls. For this reason, sirolimus is sometimes incorporated into drug-eluting stents that is, a supportive tubular structure (stent) is placed in the lumen of a partially occluded artery, and the drug is released slowly from the stent to help reduce vessel occlusion.64... 

Percutaneous coronary intervention (PCI) such as coronary angioplasty and stent implantation has become a worldwide routine strategy for coronary arterial occlusive diseases. Along with the recognition that thrombus formation is very likely to be involved in acute coronary syndrome (ACS), selection of the optimal anticoagulant is becoming essential to achieve reliable anticoagulation for successful PCI. 

Degertekin M, Sonmez K, Gencbay M, et al. Heparin-coated stent implantation in chronic total occlusion. 3rd International Congress on Coronary Artery Disease, Lyon, France, Oct 2-5, 2000 67. 

Hoye A, Tanabe K, Lemos PA, et al. Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions. J Am Coll Cardiol 2004 43(1 I) 1954-1958. 

Ge L, lakovou I, Cosgrave J, et al. Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions. Eur HeartJ 2005 26(1 I) 1056-1062,... 

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