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Preclinical evaluation of endoscopic placement of a steroid-eluting metal stent in an in vivo porcine benign biliary stricture model

 Sung Ill Jang  ;  Sungsoon Fang  ;  Ji Hae Nahm  ;  Jae Hee Cho  ;  Min Young Do  ;  Su Yeon Lee  ;  Seok Jeong  ;  Don Haeng Lee  ;  Dong Ki Lee 
 SCIENTIFIC REPORTS, Vol.12(1) : 8864, 2022-05 
Journal Title
Issue Date
Animals ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholestasis* / therapy ; Constriction, Pathologic / surgery ; Device Removal ; Stents / adverse effects ; Steroids ; Swine ; Swine, Miniature ; Treatment Outcome ; Triamcinolone
Treatment of benign biliary strictures (BBS) using fully covered self-expandable metal stents (FCSEMS) has a high success rate, but recurrence can occur. Corticosteroids may be useful based on their anti-fibrotic and anti-inflammatory effects. We investigated the safety and efficacy of corticosteroid-eluting FCSEMS in an animal model. BBSs were created by radiofrequency ablation in 12 mini-pigs. Four weeks later, FCSEMS coated with 0 mg (control), 15 mg (steroid 1 × group), or 30 mg (steroid 2 × group) triamcinolone were inserted endoscopically. The in vitro drug release assay revealed that the optimal stent had 15 mg of triamcinolone and a hydrophilic membrane. No transmural necrosis or perforation occurred in any animal. Fibrous wall thickness tended to decrease macroscopically and microscopically in a triamcinolone dose-dependent manner (control vs. steroid 2 × group: 773.1 vs. 468.5 µm, P = 0.037). Thickness also decreased over time in the steroid 2 × group (3 days vs. 4 weeks: 907.9 vs. 468.5 µm, P = 0.025). Blood parameters tended to improve after stent insertion. In a porcine BBS model, steroid-eluting FCSEMS showed potential as a safe and effective treatment modality to reduce fibrotic tissue. Studies are required to confirm their safety and efficacy in humans with refractory BBS.
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1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Nahm, Ji Hae(남지해) ORCID logo https://orcid.org/0000-0003-0902-866X
Do, Min-Young(도민영)
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
Cho, Jae Hee(조재희) ORCID logo https://orcid.org/0000-0003-4174-0091
Fang, Sungsoon(황성순) ORCID logo https://orcid.org/0000-0003-0201-5567
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