Study from Spain reports mid-term outcomes with biodegradable biliary stent

Eva Criado Paredes

It is safe and effective to place biodegradable biliary stents to treat benign biliary strictures. This treatment compares favourably with standard techniques in terms of patients’ quality of life and avoids the need for repeated invasive procedures, found a study recently presented at the CIRSE conference (26–30 September, Lisbon, Portugal).

Eva Criado Paredes, Interventional Radiology, UDIAT-CD, Corporació Sanitària Parc Taulí, Barcelona, Spain, and colleagues set out to evaluate the safety and efficacy of percutaneous insertion of biodegradable biliary stents in the treatment of benign biliary strictures. They presented follow-up out to a mean of 20 months (±14, standard deviation).

The investigators prospectively included 17 patients with symptomatic benign biliary strictures to be treated by percutaneous insertion of biodegradable polydioxanone biliary stents (Ella-DV biliary stent, Ella-CS) over a four-year period. All patients had previously undergone multiple (1 to 7, average 3.2) unsuccessful attempts of standard endoscopic and/or percutaneous treatments such as bilioplasty.

“In all, we deployed 20 biodegradable stents to treat 14 anastomotic and six non-anastomotic biliary strictures. We then evaluated the safety and technical success intraprocedurally, and treatment outcomes and complications in the follow-up period (mean 20 months [3.5–50.3]),” Criado Paredes said.

The investigators found that all the stents were successfully deployed with immediate restoration of biliary patency. They observed the following major complications: one case of frank haemobilia during the procedure that led to stent migration after four days and one case of choleperitoneum. Further, during the follow-up period, one patient developed stent occlusion due to old clots, which was solved with percutaneous clearance and two patients had episodes of transient cholangitis, one of them with evidence of restenosis leading to invasive re-treatment. At the end of the follow-up, just one patient was still symptomatic due to restenosis.

The authors highlighted that the use of the biodegradable stent avoided a need for repeated invasive procedures thus decreasing the patients’ overall hospital stay and risk of potential complications.

Earlier in the year, Giovanni Mauri (Milan, Italy) reported the results of a retrospective, multicentre study on the treatment of benign biliary strictures with the same bioresorbable biliary stent at the European Congress of Radiology (ECR, Vienna, Austria).

Mauri told Interventional News: “Bioresorbable biliary stents are important because they offer an additional treatment option for patients in whom standard treatments (bilioplasty or sustained dilation) have failed, potentially sparing a surgical re-operation. Degradation of the stent occurs by hydrolysis in about six months and the radial strength is reduced by 50% in about six to eight weeks.”