Makutani S, Yoshioka T, Uchida H, Tanaka T, Yoshimura H, Ohishi H, Iwasaki S, Ide K, Ueda K, Maeda M
Department of Radiology, Higashiosaka City General Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 2000 Jul;60(8):434-8.
An inner-covered Spiral Z-stent (IC-SZ) developed by our group was examined for its effectiveness in preventing migration by experimental comparison with commercially available esophageal covered stents.
The following six types of stents were used: inner-covered Spiral Z-stents with diameters of 16 mm (small IC-SZ) and 19 mm (large IC-SZ), outer-covered Spiral Z-stent (OC-SZ), covered Wallstent, covered Ultraflex stent, and Cook Z-stent. Experimental models were prepared using clay to simulate stenosis of the esophagogastric junction or anastomosis site due to tumor, and each stent was placed in the clay. After the stent had been fully expanded with a balloon catheter, one of its ends was pulled until the stent migrated out of the clay, and the traction force was measured. The inner cavity of the stent placed in the clay was observed using an endoscope.
The mean maximal traction force required to pull the stents out of the clay were as follows, in decreasing order: 4.14 +/- 0.39 kg for the large IC-SZ, 4.12 +/- 0.83 kg for the small IC-SZ, 3.64 +/- 0.44 kg for the Cook Z-stent (p < 0.05), 3.34 +/- 0.62 kg for the covered Ultraflex stent (p < 0.05), 1.53 +/- 0.43 kg for the OC-SZ (p < 0.01), and 0.56 +/- 0.16 kg for the covered Wallstent (p < 0.01). The force required to pull out the large IC-SZ stent was the greatest, showing a significant difference from the values for the other four types of stents (excluding the small IC-SZ). Observation using an endoscope revealed that the wire of the IC-SZ stent was almost entirely embedded in the clay, whereas the wires of other stents were not.
The IC-SZ stent may be less likely to migrate than other esophageal covered stents.
通过与市售食管覆膜支架进行实验比较，研究本团队研发的内覆螺旋Z形支架（IC-SZ）在防止移位方面的有效性。
使用以下六种类型的支架：直径为16mm的内覆螺旋Z形支架（小型IC-SZ）和19mm的内覆螺旋Z形支架（大型IC-SZ）、外覆螺旋Z形支架（OC-SZ）、覆膜Wallstent支架、覆膜Ultraflex支架和Cook Z形支架。使用黏土制备实验模型，模拟因肿瘤导致的食管胃交界或吻合口狭窄，将每个支架置入黏土中。用球囊导管使支架充分扩张后，拉动其一端直至支架移出黏土，并测量牵引力。使用内窥镜观察置入黏土中的支架内腔。
将支架从黏土中拉出所需的平均最大牵引力如下，从大到小依次为：大型IC-SZ为4.14±0.39kg，小型IC-SZ为4.12±0.83kg，Cook Z形支架为3.64±0.44kg（p<0.05），覆膜Ultraflex支架为3.34±0.62kg（p<0.05），OC-SZ为1.53±0.43kg（p<0.01），覆膜Wallstent支架为0.56±0.16kg（p<0.01）。拉出大型IC-SZ支架所需的力最大，与其他四种类型支架（不包括小型IC-SZ）的值相比有显著差异。内窥镜观察显示，IC-SZ支架的金属丝几乎完全嵌入黏土中，而其他支架的金属丝则没有。
与其他食管覆膜支架相比，IC-SZ支架移位的可能性可能较小。
