Wallstent

De Scheerder I, Szilard M, Huang Y et al, Evaluation of the effect of oversizing on vascular injury, thrombogenicity and neointimal hyperplasia using the Magic Wallstent in a porcine coronary model [abstr], JACC 2000 35(2) 70A. 

Jeong M, Owen W, Staab M, et al. Does heparin release coating of the Wallstent limit thrombosis and platelet deposition Results in a porcine carotid injury model [abstr]. Circulation 1995 92 1-37. 

Alberts MJ for the Publications Committee of the WALLSTENT (2001). Results of a multicentre prospective randomised trial of carotid artery stenting vs. carotid endarterectomy. Stroke 32 325... 

FIGURE 9.7 Self-expandable carotid stents (closed cell). (A) X-act (Abbott Vascular, Redwood City, CA) (B) NexStent (Boston Scientific, Boston, MA/EndoTex, Cupertino, CA) (C) Carotid Wallstent (Boston... 

Spiral Z-stent Za-stent Wallstent Ultraflex diamond Endocoif... 

Fig. 1.12. a Fluoroscopy is used to observe the Wallstent during deployment to ensure correct position, b The stent is ideally... 

Five randomized, prospective, controlled trials have compared plastic (polyethylene) stents and SEMS (Wallstent, BSC, Natick, MA). While SEMS... 

Abramson AF, Javit DJ, Mitty HA et al (1992) Wallstent migration following deployment in right and left bile ducts. JVIR 3 463 65... 

Prat F, Chapat O, Ducot B et al (1998) A randomized trial of endoscopic drainage methods for inoperable malignant strictures of the common bile duct Gastrointest Endosc 47 1-7 Raijman I (1999) The wallstent for benign biliary obstruction. 

Stoker J, Lamaris JS (1993) Complications of percutaneously inserted Wallstents. JVIR 4 767-772 Storkson RH, Edwin B,Reiertsen O et al (2000) Gut perforation caused by biliary endoprosthesis. Endoscopy 32 87-89 Strohm WD (1984) Limits of conventional abdominal sonography and features of endoscopic sonography. Scand J Gastroenterol [SuppI] 94 7-12... 

Fig. 2.3. Deployment of a covered Wallstent. As the outer sheath (arrows) is retracted, the stent is exposed and expands by its own radial force...

The covered stent has a layer of polyurethane on the outside of the mesh of the stent Similar to the Wallstent, the covered design has uncovered portions at either end. The covered stents are available in 17-mm and 22-mm diameter versions (unflared portions), and the uncovered stents are available in 18-mm and 23-mm diameter designs. The stents are available in the following lengths 7 cm (uncovered version only), 10 cm, 12 cm, and 15 cm. The dehvery system is 16.5-F diameter. 

In total, 15-18 migrated Wallstents were deployed across the gastroesophageal junction... 

Metallic stents were compared with laser therapy in a prospective triple-randomized study. A total of 60 patients with unresectable tumors were randomized to treatment with endoscopic laser therapy (18 patients), covered Wallstent endoprostheses (23 patients), and uncovered Strecker stents (19 patients). Both types of stents produced significantly better dysphagia relief than laser therapy (p<0.02) (Adam et al 1997). 

Fig. 2.16a,b. Total migration of a covered stent, a This patient with a distal malignant stricture was treated with a covered Wallstent. b Esophagography 24 h later showed that the stent had migrated totally into the stomach. The stricture (arrows) was no longer covered by the stent A new stent was inserted and the migrated stent was removed surgically because of abdominal discomfort... 

The results of the largest series of stenting for malignant fistulas and perforations are presented in Table 2.3 (Morgan et al. 1997 Saxon et al. 1995 Han et al. 1996 Mohammed and Moss 1996 Nicholson et al. 1995 Raijman et al. 1998). All types of covered stents have been found to be effective in the treatment of leaks and fistulas. Clinical success, defined as successful closure of the fistula or leak, occurs in 67%-100% of patients. The largest series involved 39 patients with 19 perforations and 20 fistulas, treated with covered Wallstent endoprostheses (36 patients) and covered Gianturco stents (three patients) at Guy s Hospital. The technical... 

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