Technical feasibility and tissue reaction after silicone-covered biodegradable magnesium stent insertion in the oesophagus: a primary study in vitro and in vivo

Eur Radiol. 2017 Jun;27(6):2546-2553. doi: 10.1007/s00330-016-4602-1. Epub 2016 Oct 4.

Abstract

Objectives: Determine the feasibility of and tissue response to biodegradable magnesium-silicone stent insertion into the oesophagus of rabbits.

Methods: Mechanical compression-recovery and degradation behaviours of the stents were investigated in vitro. Thirty rabbits were randomly divided into a magnesium-silicone stent group (n = 15) that received stent insertion into the lower 1/3 of the oesophagus under fluoroscopic guidance and a control group (n = 15). Oesophagography was performed at 1, 2 and 4 weeks. Five rabbits in each group were euthanized at each time point for histological examination.

Results: Magnesium-silicone stents showed good flexibility and elasticity, and degraded more slowly than bare stents at pH 4.0 and 7.4. All stent insertions were well tolerated. The oesophageal diameters at 1, 2 and 4 weeks were 9.7 ± 0.7, 9.6 ± 0.8 and 9.6 ± 0.5 mm, respectively (vs. 9.2 ± 0.8 mm before intervention; P > 0.05). Stent migration occurred in six rabbits (one at 1 week, one at 2 and four at 4). Microscopy demonstrated dilation of the oesophageal wall within 1 week of insertion. Oesophageal injury and collagen deposition following stent insertion were similar to control (P > 0.05).

Conclusions: Oesophageal magnesium-silicone stent insertion was feasible and provided reliable support for 2 weeks without causing oesophageal injury or collagen deposition.

Key points: • Mg stent provided apparently adequate radial force and silicone membrane reduced magnesium biodegradation • Stent insertion provided good support for at least 2 weeks before biodegradation • Stenting effectively resulted in oesophageal wall remodelling, without demonstrable injury.

Keywords: Biodegradation; Interventional radiology; Magnesium; Oesophagus; Stent.

MeSH terms

  • Absorbable Implants*
  • Animals
  • Esophagus / surgery*
  • Feasibility Studies
  • Female
  • Foreign-Body Migration
  • Humans
  • In Vitro Techniques
  • Magnesium / pharmacology*
  • Male
  • Prosthesis Design
  • Rabbits
  • Random Allocation
  • Silicone Elastomers / pharmacology*
  • Stents*

Substances

  • Silicone Elastomers
  • Magnesium