CardioVascular and Interventional Radiology

, Volume 30, Issue 4, pp 705–710 | Cite as

Initial Experience with the Resonance Metallic Stent for Antegrade Ureteric Stenting

Clinical Investigation

Abstract

Background and purpose

We describe our initial experience with a new metallic ureteric stent which has been designed to provide long-term urinary drainage in patients with malignant ureteric strictures. The aim is to achieve longer primary patency rates than conventional polyurethane ureteric stents, where encrustation and compression by malignant masses limit primary patency. The Resonance metallic double-pigtail ureteric stent (Cook, Ireland) is constructed from coiled wire spirals of a corrosion-resistant alloy designed to minimize tissue in-growth and resist encrustation, and the manufacturer recommends interval stent change at 12 months.

Methods

Seventeen Resonance stents were inserted via an antegrade approach into 15 patients between December 2004 and March 2006. The causes of ureteric obstruction were malignancies of the bladder (n = 4), colon (n = 3), gynecologic (n = 5), and others (n = 3).

Results

One patient had the stent changed after 12 months, and 3 patients had their stents changed at 6 months. These stents were draining adequately with minimal encrustation. Four patients are still alive with functioning stents in situ for 2–10 months. Seven patients died with functioning stents in place (follow-up periods of 1 week to 8 months). Three stents failed from the outset due to bulky pelvic malignancy resulting in high intravesical pressure, as occurs with conventional plastic stents.

Conclusion

Our initial experience with the Resonance metallic ureteric stent indicates that it may provide adequate long-term urinary drainage (up to 12 months) in patients with malignant ureteric obstruction but without significantly bulky pelvic disease. This obviates the need for regular stent changes and would offer significant benefit for these patients with limited life expectancy.

Keywords

Antegrade Metal Percutaneous Ureteric stents 

References

  1. 1.
    Docimo SG, Dewolf WC (1989) High failure rate of indwelling ureteral stents inpatients with extrinsic obstruction: Experience at 2 institutions. J Urol 142:277–279PubMedGoogle Scholar
  2. 2.
    Chitale SV, Scott-Barrett S, Ho ET, et al. (2002) The management of ureteric obstruction secondary to malignant pelvic disease. Clin Radiol 57:1118–1121PubMedCrossRefGoogle Scholar
  3. 3.
    Barbalias GA, Siablis D, Liatsikos EN, et al. (1997) Metal stents: A new treatment of malignant ureteral obstruction. J Urol 158:54–58PubMedCrossRefGoogle Scholar
  4. 4.
    Lang EK, Irwin RJ, Lopez-Martinez RA, et al. (1998) Placement of metallic stents in ureters obstructed by carcinoma of the cervix to maintain renal function in patients undergoing long term chemotherapy. AJR Am J Roentgenol 171:1595–1599PubMedGoogle Scholar
  5. 5.
    vanSonnenberg E, D’Agostino HB, O’Laoide R, Donaldson J, Sanchez RB, Hoyt A, Pittman CC (1994) Malignant ureteral obstruction: Treatment with metal stents. Technique, results, and observations with percutaneous intraluminal US. Radiology 191:765–768PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Department of RadiologySt. James’s University HospitalLeedsUK
  2. 2.Department of UrologySt. James’s University HospitalLeedsUK

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