Partially Covered Versus Uncovered Self-Expandable Metal Stents: Coating Nor Diameter Affect Clinical Outcomes

Area of Science:

• Gastroenterology and Hepatology
• Interventional Endoscopy
• Biliary Tract Diseases

Background:

• Malignant biliary stricture often presents with jaundice, requiring intervention.
• Self-expanding metal stents (SEMS) are preferred over plastic stents for longer patency and fewer complications in patients with prognoses exceeding 3 months.
• Existing literature presents conflicting data on the comparative efficacy and safety of different SEMS types and diameters.

Purpose of the Study:

• To compare the clinical outcomes of coated (PCSEMS) versus uncoated (USEMS) self-expanding metal stents.
• To evaluate the impact of stent diameter (8mm vs. 10mm) on clinical outcomes in malignant biliary obstruction management.
• To determine if stent coating or diameter influences clinical success rates and patency duration.

Main Methods:

• Retrospective cohort study including 278 patients undergoing ERCP with biliary SEMS placement (8mm and 10mm diameters) between 2009 and 2017.
• Patients were divided into groups based on stent coating (PCSEMS vs. USEMS) and diameter.
• Comparison of clinical success rates, patency duration, and adverse event rates between the different SEMS types and diameters.

Main Results:

• No statistically significant difference in clinical success rates between PCSEMS (98.1%) and USEMS (95.5%).
• Patency duration was not significantly different between PCSEMS (302.5 days) and USEMS (225.5 days).
• Stent diameter (8mm vs. 10mm) also showed no impact on overall clinical success or patency duration.

Conclusions:

• Stent coating (PCSEMS vs. USEMS) did not demonstrate a significant difference in clinical efficacy or adverse events.
• Stent diameter (8mm vs. 10mm) did not impact clinical success or patency duration in managing malignant biliary obstruction.
• Findings suggest that stent coating and size may not be critical factors in SEMS selection for this indication, contrary to some prior suggestions.