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Newly designed OTS Clip for preventing fully-covered self-expandable metal stent migration in the gastrointestinal tract
Background and study aims Fully-covered self-expandable metal stents (FCSEMS) are frequently used for endoscopic management of gastrointestinal lesions. However, stent migration occurs in up to one-third of patients. Different tools are used to anchor stents to prevent migration. A specifically designed over-the-scope device (Stentfix OTS Clip system) was recently introduced to prevent fully covered SEMS migration in the gastrointestinal tract. The study aimed to evaluate technical success and stent migration rates with the Stentfix device.
Patients and methods Data were collected from consecutive patients at four participating centers who were at high risk of FCSEMS migration and in whom the anchoring system was used to prevent migration.
Results A total of 31 patients were enrolled. Technically successful clip placement was achieved in all cases. At follow-up, the distal part of the device dislocated from the duodenum into the antrum at 3 days in one patient, accounting for a 3.2 % (95 % CI = 0–9.4) rate of stent migration. The underlying lesion being treated healed in all patients, but 10 patients died before stent removal due to neoplastic progression.
Conclusions A dedicated over-the-scope stent fixation device appears to be safe and effective in preventing fully-covered SEMS migration through the gastrointestinal tract.
Received: 30 May 2022
Accepted after revision: 11 October 2022
Article published online:
24 March 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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- 1 Spaander MC, Baron TH, Siersema PD. et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 939-948
- 2 Vanbiervliet G, Filippi J, Karimdjee BS. et al. The role of clips in preventing migration of fully covered metallic esophageal stents: a pilot comparative study. Surg Endosc 2012; 26: 53-59
- 3 Schiemer M, Bettinger D, Mueller J. et al. Reduction of esophageal stent migration rate with a novel over-the-scope fixation device. Gastrointest Endosc 2022; 96: 1-8
- 4 Wang C, Lou C. Randomized controlled trial to investigate the effect of metal clips on early migration during stent implantation for malignant esophageal stricture. Can J Surg 2015; 58: 378-382
- 5 Irani S, Baron TH, Gluck M. et al. Preventing migration of fully covered esophageal stents with an over-the-scope clip device (with videos). Gastrointest Endosc 2014; 79: 844-851
- 6 Law R, Prabhu A, Fujii-Lau L. et al. Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis. Surg Endosc 2018; 32: 675-681
- 7 Conio M, Savarese MF, Baron TH. et al. A newly designed over-the-scope-clip device to prevent fully covered metal stents migration: A pilot study. Tech Inn Gastrointest End 2020; 22: 167-171
- 8 Zimmer V. Sequential duodeno-biliary double metal stenting in Mutignani type I obstruction facilitated by stentfixOTSC anchoring device. Ann Gastroenterol 2021; 34: 286
- 9 Kantsevoy SV, Bitner M. Esophageal stent fixation with endoscopic suturing device (with video). Gastrointest Endosc 2012; 76: 1251
- 10 Hori Y, Hayashi k, Naitoh I. et al. A pilot study of novel duodenal covered self expandable metal stent fixation. Scientific Rep 2021; 11: 19708
- 11 Watanabe K, Hikichi T, Nakamura J. et al. Feasibility of esophageal stent fixation with an over-the-scope-clip for malignant esophageal strictures to prevent migration. Endosc Int Open 2017; 05: E1044-E1049
- 12 Hori Y, Hayashi K, Naitoh I. et al. Feasibility and safety of duodenal covered self-expandable metallic stent fixation: an experimental study. Surg Endosc 2019; 33: 4026-4031