Freudenberg S, Hartel M, Fernandez F, Schuster K L, Kammermaier V, Haberstroh J, Schmoll J, Manegold B C, Hasse J
Chirurgische Klinik, Fakultät für klinische Medizin Mannheim der Universität Heidelberg, Germany.
Endoscopy. 2000 Jan;32(1):49-53. doi: 10.1055/s-2000-131.
Intraluminal stenting of organs with stenoses or fistulae in anatomically difficult locations (for instance cardia, pylorus, large bowel), with a tendency to kinking or increased motility, still carries a high risk of stent dislocation. In the search for a solution, we report on the use of a new thermoplastic stent in animal experiments.
The new stent consists of a plastic-coated wire mesh which can be heated electrically. Once it is warmed up to 55 C, its size and shape can be changed. After being expanded by a dilatation balloon across the stenosed area, the stent can be fitted onto the inner organ surface. This guarantees a low dislocation risk and high stability. In an animal experiment, stents were endoscopically placed in the trachea and the surgically stenosed esophagus of two dogs. The animals were observed for 3 months.
The thermostents were implanted easily and without complications. It was possible to mold the thermostent evenly onto the intraluminal wall. No stent dislocation, bleeding or perforation was observed. Upon histologic evaluation, granulation tissue was found to be growing through the wire mesh of the stent.
It was shown that the stent described here can be implanted without major problems. The greater effort of the implantation procedure, in comparison with self-expanding stents, is compensated by the special mechanical characteristics of the stent. These characteristics may permit implantation in anatomically difficult locations where up to now stenting has been impossible or inadequate.
对解剖位置困难（如贲门、幽门、大肠）存在狭窄或瘘管且有扭结倾向或蠕动增强的器官进行腔内支架置入，仍存在较高的支架移位风险。为寻求解决方案，我们报告了一种新型热塑性支架在动物实验中的应用。
新型支架由可电加热的塑料涂层金属丝网组成。一旦加热至55摄氏度，其尺寸和形状即可改变。通过扩张球囊在狭窄区域扩张后，支架可贴合于器官内表面。这保证了低移位风险和高稳定性。在一项动物实验中，通过内镜将支架置入两只狗的气管和手术造成狭窄的食管中。对动物观察3个月。
热塑性支架易于植入且无并发症。能够将热塑性支架均匀地塑形于腔内壁上。未观察到支架移位、出血或穿孔。组织学评估发现有肉芽组织长入支架的金属丝网中。
结果表明，此处所述的支架能够顺利植入。与自膨胀支架相比，植入过程虽更为复杂，但该支架特殊的机械特性弥补了这一不足。这些特性可能允许在迄今为止无法进行支架置入或置入效果不佳的解剖位置困难处进行植入。
