Preliminary experience of the use of a self-expanding nititol stent in refractory variceal bleeding: a real-world study

Rev Esp Enferm Dig. 2024 Sep;116(9):516-517. doi: 10.17235/reed.2023.10035/2023.

Abstract

Background and aims: The fully-covered self-expanding metal stent (SEMS) has a role in the management of refractory acute variceal haemorrhage. The aim of this study was to evaluate its effectiveness and complications in real-world practice.

Patients and methods: An observational, descriptive, multicenter study was carried out. Eight patients with clinically significant portal hypertension who underwent a SEMS were included.

Results: SEMS placement controlled acute bleeding in 7 patients with technical success. Stents were removed after a median of 8 days. Rescue transjugular intrahepatic portosystemic shunt was performed around 48 hours after SEMS placement. Four patients survived after successful SEMS removal. The most common adverse event was stent loop in 2 patients.

Conclusions: In our experience, SEMS was highly effective in controlling acute refractory variceal bleeding. Bleeding-related mortality rate was probably due to impossibility of TIPS implantation. Stent loop was a common limiting factor.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Alloys
  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / surgery
  • Esophageal and Gastric Varices* / therapy
  • Female
  • Gastrointestinal Hemorrhage* / etiology
  • Gastrointestinal Hemorrhage* / therapy
  • Humans
  • Hypertension, Portal / complications
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Self Expandable Metallic Stents*
  • Stents / adverse effects
  • Treatment Outcome

Substances

  • Alloys