Pyeloureteral stenting using nitinol stents


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Aim To test the effectiveness of nitinol stents in restoring patency of pyeloureteral segment (PUS). Materials and methods Endoureteral nitinol stents were used in 54 patients. The indications for stenting were recurrent strictures of upper urinary tract and ureteral tumor obstruction in 34 and 20 patients, respectively. In 9 (16.6%) of them, including 4 women and 5 men aged 28-65 years, stenting was performed for extensive recurrent PUS strictures. In 8 patients extensive strictures resulted from various surgical interventions on the PUS. In 2 patients, PUS narrowing was caused by open pyelolithotomy, in 6 patients by pyeloplasty, both open (4) and laparoscopic (2). A female patient with solitary right kidney and Bourneville - Pringle disease of the PUS received two metal prostheses. Results In all cases, nitinol stents were adequately installed in PUS. Hematuria was observed in 1 patient. During the follow-up period of 8 to 60 months, the results of stenting were considered good in 6 (66.7%) and satisfactory in 2 (22.2%) patients. At month 10, 1 (11.1%) patient developed the stent obstruction by proliferative tissue and underwent ureteroscopy with recanalization of the nitinol stent. The patient with Bourneville - Pringle disease was found to have a stone formed in the renal pelvic end of the endoprosthesis; she underwent percutaneous nephrolithotripsy. In another patient a lower calyceal stone migrated and wedged into the proximal end of the stent. The stone was extracted using percutaneous nephroscopy. Conclusion Pyeloureteral stenting is an effective method to restore patency of the PUS in patients with extensive recurrent strictures. For adequate functioning of the stents, they need to be of optimal length and correctly installed.

Full Text

Restricted Access

About the authors

B. G Guliev

I.I. Mechnikov North-Western State Medical University

Email: gulievbg@mail.ru
Dr.Med.Sci., Prof. at the Department of Urology

A. M Zagazezhev

I.I. Mechnikov North-Western State Medical University

Department of Urology

References

  1. Карев А.В., Рыжков В.К., Петрова С.Н., Борисов А.Е. Новый стент из мононити в создании чрескожного чрезпеченочного портосистемного соустья. Вестник рентгенологии и радиологии. 2003;5:40-42
  2. Coons H.G. Self-expanding stainless steel biliary stents. Radiology 1989;170:979.
  3. Sigwart U., Puel J., Mirkovitch B. et al. Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. N. Engl. J. Med. 1987;316:710.
  4. Ponholzer A., Marszalek M., Madersbacher S. Minimally invasive treatment of BPH: an update. Eur Urol. 2004;2 (1 Suppl.):24-43.
  5. Van Dijk M., Mochtar C., Laguna P. et al. The use of a nitinol thermo-expandable bel-shaped prostatic stent in benign prostatic hyperplasia (BPH): a feasibility study. Eur Urol. 2004; 3 (2 Suppl.): 142.
  6. Комяков Б.К., Гулиев Б.Г. Реканализация мочеточника. СПб., Диалект, 2011. 202 с.
  7. Курбатов Д.Г., Мартов А.Г., Дубский С.А., Лепетухин А.Е., Андреев Ю.Г., Рафф Л. С. Применение временных нитиноловых эндопротезов с полиуретановым покрытием в лечении стриктур уретры. Урология. 2016;1:82-85
  8. Lang E.K., Winer A.G., Abbey-Mensah G. et al. Long-term results of metallic stents for malignant ureteral obstruction in advanced cervical carcinoma. J. Endourology. 2013;27(5):645-651.
  9. Burgos F.J., Linares A., Gomez V. et al. Efficacy of self-expanding metallic stents for treatment of ureteral obstruction. Eur. Urol. 2001;39(5 Suppl.):86.
  10. Papatsoris A.G., Buchnolz N. A novel thermo-expandable ureteral metal stent for the minimally invasive management of ureteral strictures. J. Endourol. 2010;24:487-491.
  11. Bourdoumis A., Kachrilas S., Kapoor S. et al. The use of a thermo-expandable metal alloy stent in the minimally invasive management of retroperitoneal fibrosis: a single center experience from the United Kingdom. J. Endourology. 2014;28(1):96-99.
  12. Barbalias G.A., Liatsikos E.N., Karnabatidis D. et al. Ureteroileal anastomosic strictures: an innovative approach with metallic stents. J. Urol. 1998;160:1270.
  13. Palascak P., Bouchareb M., Zachoval R. et al. Treatment of ureteroenteric anastomotic strictures with permanent ureteral Wallstents after Camey and Wallace urinary diversion: long-term follow-up. Eur. Urol. 2001;39(5):86.
  14. Мартов А.Г., Ергаков Д.В., Ларионов И.Н., Голубев М.Ю. Комбинированное лечение папиллярных опухолей лоханки и мочеточника единственной почки в сочетании с эндопротезированием мочеточника. Урология. 2005;5:62-64
  15. Гулиев Б.Г., Загазежев А.М. Результаты эндопротезирования протяженных сужений мочеточника нитиноловыми стентами. Эндоскопическая хирургия. 2013;2:31-35
  16. Гулиев Б.Г., Загазежев А.М. Отдаленные результаты эндопротезирования протяженных сужений мочеточника нитиноловыми стентами. Экспериментальная и клиническая урология. 2015;2:64-67
  17. Яровой С.Ю., Максимов В.А., Медведев Е.В., Ачба З.О., Шоуа А.Б., Маркарян С.В. Отдаленные результаты использования стентов из никелида титана при стриктурах мочеточника различной локализации-собственный опыт. Вестник урологии. 2016;1:12-23
  18. Barbalias E., Liatsikos E.N., Kagadis G.C. et al. Ureteropelvic junction obstruction: an innovative approach combining metallic stenting and virtual endoscopy. J. Urol. 2002;168:2383-2386.
  19. Liatsikos E., Karnabatidis D., Kagadis G.C. et al. Application of Paclitaxel - eluting metal mesh stents within the pig ureter: an experimental study. Eur. Urol. 2007;51:217-223.
  20. Kallidonis P.S., Georgiopoulos I.S., Kyriazis I.D., Al-Aown A.M., Liatsikos E.N. Drug-eluting metallic stents in urology. Indian J. Urol. 2014;30(1):8-12.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies