Abstract
Newly developed transrenal ureteral occlusion self-expanding metallic stents (SEMSs) are applied in patients with inoperable fistulas. In this study, the occlusive properties of M- and D-type occlusion SEMSs were investigated in 3D-printed phantom and ex vivo porcine urinary tracts. In the former, the mean bursting pressure causing leakage of contrast medium through the occlusion SEMS was relatively higher in M-types (42.8 ± 3.8 mmHg) than in D-types (38.8 ± 3.8 mmHg), without a statistical difference (p = 0.075). In the latter, the bursting pressure causing leakage through the M-type occlusion SEMS (110.7 ± 8.6 mmHg) was significantly higher than that of the D-type occlusion SEMS (93.8 ± 11.2 mmHg, p = 0.015); however, the mean bursting pressures causing contrast blowout did not differ between the two types (178.7 ± 11.2 mmHg vs. 176.2 ± 11.8 mmHg, p = 0.715). In conclusion, M- and D-type occlusion SEMSs showed similar efficacy in occlusive properties in the 3D phantom study; however, the M-type was superior in the ex vivo porcine urinary tract model. Further in vivo experimental studies are required to confirm these experimental results.
Highlights
Fistulas of the lower urinary tract are serious complications that can occur after treating various pelvic abnormalities [1,2,3,4]
All occlusion SEMSs were successfully placed into the 3D-printed phantom
M- and D-type occlusion SEMSs showed a similar efficacy in occlusive properties in the 3D phantom study; superiority of M-type was observed in the ex vivo porcine urinary tract model
Summary
Fistulas of the lower urinary tract are serious complications that can occur after treating various pelvic abnormalities [1,2,3,4]. Surgical management, such as ureterostomy and ureteral clipping, is the standard palliative treatment of such fistulas; most fistulas are inoperable [1,4]. Percutaneous occlusion of urinary flow has been investigated using various materials, such as detachable balloons, embolization coils, Amplatzer vascular plugs, n-butyl cyanoacrylate, and combinations thereof [2,3,4,7,14,15,16,17,18]. Additional studies are required to prove their efficacy and safety in preclinical research
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