Silicone-covered biodegradable magnesium stent for treating benign esophageal stricture in a rabbit model

World J Gastroenterol. 2019 Jul 7;25(25):3207-3217. doi: 10.3748/wjg.v25.i25.3207.

Abstract

Background: Stent insertion can effective alleviate the symptoms of benign esophageal strictures (BES). Magnesium alloy stents are a good candidate because of biological safety, but show a poor corrosion resistance and a quick loss of mechanical support in vivo.

Aim: To test the therapeutic and adverse effects of a silicone-covered magnesium alloy biodegradable esophageal stent.

Methods: Fifteen rabbits underwent silicone-covered biodegradable magnesium stent insertion into the benign esophageal stricture under fluoroscopic guidance (stent group). The wall reconstruction and tissue reaction of stenotic esophagus in the stent group were compared with those of six esophageal stricture models (control group). Esophagography was performed at 1, 2, and 3 weeks. Four, six, and five rabbits in the stent group and two rabbits in the control groups were euthanized, respectively, at each time point for histological examination.

Results: All stent insertions were well tolerated. The esophageal diameters at immediately, 1, 2 and 3 wk were 9.8 ± 0.3 mm, 9.7 ± 0.7 mm, 9.4 ± 0.8 mm, and 9.2 ± 0.5 mm, respectively (vs 4.9 ± 0.3 mm before stent insertion; P < 0.05). Magnesium stents migrated in eight rabbits [one at 1 wk (1/15), three at 2 wk (3/11), and four at 3 wk (4/5)]. Esophageal wall remodeling (thinner epithelial and smooth muscle layers) was found significantly thinner in the stent group than in the control group (P < 0.05). Esophageal injury and collagen deposition following stent insertion were similar and did not differ compared to rabbits with esophageal stricture and normal rabbits (P > 0.05).

Conclusion: Esophageal silicone-covered biodegradable magnesium stent insertion is feasible for BES without causing severe injury or tissue reaction. Our study suggests that insertion of silicone-covered magnesium esophageal stent is a promising approach for treating BES.

Keywords: Benign esophageal stricture; Biodegradable stent; Magnesium; Silicone membrane.

MeSH terms

  • Absorbable Implants / adverse effects*
  • Animals
  • Disease Models, Animal
  • Equipment Failure
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / therapy*
  • Feasibility Studies
  • Foreign-Body Migration / epidemiology
  • Foreign-Body Migration / etiology
  • Humans
  • Magnesium / adverse effects
  • Rabbits
  • Self Expandable Metallic Stents / adverse effects*
  • Silicones / adverse effects
  • Treatment Outcome

Substances

  • Silicones
  • Magnesium