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Which Interventional Device Review: Steerable ureteric stent
Features
I have placed 4 of these stents recently. The manufacturers claim a 'high degree of ring stability, excellent pushability, biocompatability as well as a low tendancy to encrustation.'
Design/construction
The stent has a pusher fixed into its top end. The stent takes a standard wire which can then be removed leaving the stent and pusher attached. Its made from radiopaque soft polyurethane.
In Use
I was interested to see whether the 'fixed' pusher would help coil the top end of the stent in small pc systems, with a view to it being easier for juniors and less experienced consultants to place stents. We frequently have patients who are suitable for primary stenting but this is not done at the time when a non uroradiologist is dealing with the case. Part of this is due to difficulty in deploying the top end of the stent correctly with standard stents without a fixed pusher.
This stent is deployed in the usual way (I put it in through a peelaway sheath), then the wire can be removed. The stent can be repositioned and torqued to form the loop within the renal pelvis. This is particularly useful in patients with a small renal pelvis. Once this is done, the end of the pusher is depressed to finally release the stent. The system is not foolproof and the original version (shown) had an attached thread to help pull it back if it was released by accident. The newer one does not, presumably as it is better fixed to the pusher?
Conclusion
The attached pusher works well when torqued helping coild the top end. It does slide well and seems to resist buckling when meeting resistance. I am not sure of its long term resistance to encrustation. Time will tell. I cant give it 5/5 as I had one where the pusher rotated and didnt give much torque. I suspect this was a one off.
UK distributor http://www.pyramed.co.uk/
For images and full review, please visit radRounds Partner Site: WhichInterventionalDevice
http://www.whichradiologydevice.com/product-categories/uroradiology...
I have placed 4 of these stents recently. The manufacturers claim a 'high degree of ring stability, excellent pushability, biocompatability as well as a low tendancy to encrustation.'
Design/construction
The stent has a pusher fixed into its top end. The stent takes a standard wire which can then be removed leaving the stent and pusher attached. Its made from radiopaque soft polyurethane.
In Use
I was interested to see whether the 'fixed' pusher would help coil the top end of the stent in small pc systems, with a view to it being easier for juniors and less experienced consultants to place stents. We frequently have patients who are suitable for primary stenting but this is not done at the time when a non uroradiologist is dealing with the case. Part of this is due to difficulty in deploying the top end of the stent correctly with standard stents without a fixed pusher.
This stent is deployed in the usual way (I put it in through a peelaway sheath), then the wire can be removed. The stent can be repositioned and torqued to form the loop within the renal pelvis. This is particularly useful in patients with a small renal pelvis. Once this is done, the end of the pusher is depressed to finally release the stent. The system is not foolproof and the original version (shown) had an attached thread to help pull it back if it was released by accident. The newer one does not, presumably as it is better fixed to the pusher?
Conclusion
The attached pusher works well when torqued helping coild the top end. It does slide well and seems to resist buckling when meeting resistance. I am not sure of its long term resistance to encrustation. Time will tell. I cant give it 5/5 as I had one where the pusher rotated and didnt give much torque. I suspect this was a one off.
UK distributor http://www.pyramed.co.uk/
For images and full review, please visit radRounds Partner Site: WhichInterventionalDevice
http://www.whichradiologydevice.com/product-categories/uroradiology...
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