Abstract
Background & Aim: There are many commercially available metallic stents. Although, there are some data on their radial force (RF) little on axial force (the force stent being straight, AF). We performed quantitative analysis of RF and AF of stents commercially available in Japan. Methods: We investigated following 8 uncovered metallic stent (UMS) and 5 covered metallic stents (CMS): Wallstent (Wa), Diamond stent (Di), ZA stent (Za), SelfX (Se), SMART Stent (Sm), Sinus Super Flex (SSF), Luminex (Lu), Zilver Stent (Zi), Silicone-covered Wallstent (SCW), Gore-Tex (Go), Polyurethane-covered Wallstent (PCW), Polyurethane-covered Diamond stent (PCD) and ComVi Stent (Co). All the stents were prepared as 10 mm × 8 cm size and measured the RF and AF on 2 stents on each for mean score. The environment was room temperature (37°C). RF is measured by radial force measuring machine (RX500; Machine Solutions Inc.). AF is measured when stents were bended 60°. We analyzed relation of these measured data and clinical outcome. Result: 1) RF strength of UMS was in following order: Sm>SSF>Za>Lu>Se>Wa >Zi>Di. RF strength of CMS was in following order: Co>Go>PCW>PCD>SCW. 2) AF strength of UMS was in following order: Wa>Lu>Sm>SSF>Za>Di>Zi>Se. AF strength of CMS was in following order: SCW>PCW>PCD>Go>Co. AF is depends on the distance between fulcrum and measuring point; AF is getting weak when the distance is wide. 3) Clinical experience of CMS included SCW in 69 cases, PCW in 21 and PCD in 57. Complication rate was 35%, 14% and 16%, respectively. Bile duct kink rate was 4%, 5% and 0% and mean patency duration was 166 days, 188 days and 304 days. Conclusion: Complication rate of SCW, which has the strong AF, is the highest and mean patency duration is the shortest. Strong AF can cause kink of bile duct at stent edge. And also, it can accelerate sludge formation when stents could not attach to bile duct wall. It's possible that too much AF and RF exert a harmful influence in clinical use.
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