Effectiveness of the Ultraflex Diamond stent for the palliation of XXXX .

@entity1 @entity691 @entity1087 @entity5 @entity11710 @entity1578 @entity432 @entity204 @entity255
BACKGROUND AND STUDY AIMS: Endoscopically placed metallic biliary stents provide durable drainage for @entity5 . The best-studied metal stent is the Wallstent, which has a greater duration of patency than @entity691 stents. Recently, the Ultraflex Diamond stent has been introduced, with reports from Europe which suggest efficacy similar to that of the Wallstent. We report our experience with this new metal stent and compare it with a historical cohort of Wallstent-treated @entity1 . @entity1 AND METHODS: Between July 1997 and July 1998 all metal stents placed for @entity5 were @entity11710 stents (10 mm diameter, 6 or 8 cm length). Prospective follow-up details with regard to @entity1 @entity204 or stent occlusion were obtained. In total, 32 @entity1 underwent stenting, but 11 @entity1 were excluded because of the following: @entity204 from pre-existing @entity255 (2); placement of bilateral hilar stents (2); placement of stent through occluded metal stents (3); failure to palliate @entity1087 due to @entity1578 (1); or inability to obtain follow-up (1), leaving 21 @entity1 for analysis. Occlusion rates and stent patency were also determined retrospectively for 19 @entity1 with @entity5 who had Wallstents (10 mm diameter, 6.8 cm length) placed during the preceding year and for whom accurate and complete follow-up details were available. RESULTS: In the Diamond stent group there were 14 @entity1 and seven @entity1 , mean age 73. In the Wallstent group there were 11 @entity1 and eight @entity1 , mean age 66. The types of @entity5 , level of stricture and percentage with prior @entity691 stenting were similar in both groups. @entity432 occurred in 9/21 (43%), Diamond stents at a mean of 74 +/- 43 days compared with 8/19 (42%) Wallstents at a mean of 178 +/- 138 days (P < 0.04). Mean time of stent patency was 110 +/- 89 days for Diamond stents and 253 +/- 218 days for Wallstents (P < 0.01). Analysis of occlusion-free survival using a Kaplan-Meier plot showed a trend favoring the Wallstent (P = 0.12; Wilcoxon test). CONCLUSIONS: The occlusion rate and patency of Diamond stents for @entity5 appear to be inferior to those of Wallstents and similar to reported values for @entity691 stents. Prospective randomized comparisons of Wallstents and newer self-expanding metal stents are warranted.
