In health care, the use of medical devices is a main element. Along medicines, they are responsible for increasing health care expenditure. Biliary stents are tubular devices made of plastic (teflon, polyethylene or polyurethane) or metal (stainless steel or nickel-titanium alloy) used to relieve obstruction or stenosis in patients with both benign and malignant disease.
Plastic stents occlude due to deposition of bacterial biofilm within the stent lumen and have a mean stent patency of approximately 3 months. The most cost effective strategy to prolong stent patency is the use of larger stent diameter.
Self-expanding metal stents (SEMSs) were developed to increase stent diameter, thereby increasing the patency duration and reducing recurrent obstruction. The latter is further divided into the fully covered SEMSs, partially covered SEMSs, and uncovered SEMSs types. Covered SEMSs were designed to further prolong the duration of patency of uncovered SEMSs by preventing occlusion due to tumor ingrowth and reactive tissue hyperplasia through the stent mesh. The choice of stent depends on patient prognosis and the relative costs. In general, plastic stents are reasonable for patients surviving less than six months and metal stents more cost-effective for patients expected to live longer. An appropriate selection improves patient health care and contributes to the sustainability of the health system.
Key Words: Stent, plastics, metals, selection, medical device, biliary tract diseases.
Download PDF: Clasificación y gestión de prótesis biliares
Article in number: VOL. 26 – Nº1 – 2016