Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/29047
Title: The role of a novel self-expanding metal stent in variceal bleeding: a multicenter Australian and New Zealand experience.
Austin Authors: Khan, Saad;Gilhotra, Rajit;Di Jiang, Caroline;Rowbotham, David;Chong, Andre;Majumdar, Avik;White, Campbell;Huelsen, Alex;Brooker, Jim;O'Beirne, James;Schauer, Cameron;Efthymiou, Marios ;Vaughan, Rhys B ;Chandran, Sujievvan 
Affiliation: Gastroenterology and Hepatology
Department of Gastroenterology and Hepatology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia..
Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, Queensland, Australia..
AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia..
Department of Gastroenterology, Fiona Stanley Hospital, Perth, Western Australia..
Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia..
Department of Gastroenterology and Hepatology, Auckland District Health Board, Auckland, New Zealand..
Department of Gastroenterology, Taranaki Base Hospital, Taranaki District Health Board, New Zealand..
Department of Gastroenterology, Waikato District Health Board, Hamilton, New Zealand..
Department of Gastroenterology, Middlemore Hospital, Counties Manukau District Health Board, Auckland Hospital, New Zealand..
Victorian Liver Transplant Unit
Issue Date: 14-Mar-2022
Date: 2022
Publication information: Endoscopy international open 2022; 10(3): E238-E245
Abstract: Background and study aims  Refractory variceal bleeding is associated with high mortality in patients with chronic liver disease. A fully-covered self-expanding metal stent (SEMS) has been reported to have excellent rates of technical success and initial bleeding control; however, studies to date are small and limited to Europe and Asia. Our aim was to evaluate the efficacy and safety of this SEMS for control of refractory variceal bleeding (VB). Patients and methods  A retrospective analysis was undertaken of all patients who received the SX-ELLA Danis SEMS for management of VB at 9 tertiary centers across Australia and New Zealand. A total of 32 SEMS had been deployed in 30 patients (median age 53.3). Results  Technical success of SEMS placement was achieved in 100 % of cases, resulting in immediate control of bleeding across 31 of 32 cases (96.9 %). Re-bleeding with SEMS in situ occurred in three of 32 cases (9.4 %). Mean SEMS in-dwelling time was 6.4 days. Delayed SEMS migration occurred in 6.3 % of cases. Interventional radiological therapy for management of varices within 6 weeks was performed in 12 of 30 patients (40 %). Death with SEMS in situ occurred in seven of 30 patients (23.3 %). Seven-day bleeding-related mortality was 16.7 %, 14-day mortality 23.3 %, and 6-week mortality 33.3 %. Three of 30 patients (10 %) received orthotopic liver transplantation following SEMS insertion, including two patients within 6 weeks. Conclusions  SX-Danis Ella SEMS is highly effective for immediate control of refractory VB and bridging to definitive therapy because it has excellent technical success rates, appears to be relatively easy to use, and has low rates of serious adverse events.
URI: https://ahro.austin.org.au/austinjspui/handle/1/29047
DOI: 10.1055/a-1729-0104
ORCID: 0000-0002-3440-9774
0000-0003-2569-5163
0000-0002-4557-1734
0000-0002-5015-6287
Journal: Endoscopy international open
PubMed URL: 35295239
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35295239/
ISSN: 2364-3722
Type: Journal Article
Appears in Collections:Journal articles

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