Endoscopic hemostasis with self-expanding nitinol stents (literature review)

Abstract

Aim. A critical analysis of modern scientific publications on the application in complex treatment program of patients with acute bleeding from esophageal varices endoscopic hemostasis with self-expanding nitinol Danish stents.Methods. Literature data are presented on the results of treating patients at the height of esophageal bleeding or with a high risk of recurrence by installing self-expanding nitinol Danish stents.Results. The advantages of Danish stent include low trauma; good tolerance; physiological saliva drainage and the possibility of receiving fluid and food through the mouth; repeated endoscopic examination of the esophagus and stomach after the introduction of the stent; reducing the risk of aspiration pneumonia; the impossibility of removal or displacement by the patient in a state of excitement. The disadvantages of self-expanding nitinol Danish stents, in addition to the risk of migration from the esophagus to the stomach with loss of its plugging function, include the limitation of the therapeutic effect only to varicose veins of the esophagus, the development of small erosions or ulcers on the mucous membrane of the esophagus after stent removal.Conclusion. The extent to which endoscopic hemostasis with self-expanding nitinol Danish stents will take a strong place in the treatment of patients with variceal bleeding is not clear. In the recommendations of the Baveno VI Consensus the method is considered as an attractive alternative to Sengstaken–Blackmore balloon tamponade, however, the need for confirmation of the initial clinical results by further comparative randomized controlled trials is indicated.