ASGE Interventional IBD: Management of Complications (On-Demand)| March 2022-Endoscopic Stenting: Primetime Yet?

Video Transcription

Video Summary

In this video, Carme Lloras, an expert in endoscopic stenting, discusses the use of stents in patients with Crohn's disease. Stenosis is a common complication of Crohn's disease, often requiring surgery. However, endoscopic stenting has been shown to be a safe and effective alternative to surgery, with a success rate of 60% to 80% and a low rate of major complications.<br /><br />There are different types of stents available, including fully and partially covered metal stents, lumen-opposing metal stents, and biodegradable stents. The evidence for the efficacy and safety of stents in treating stenosis in patients with inflammatory bowel disease (IBD) is limited but growing.<br /><br />Several studies and case reports have been published on the use of stents in IBD patients. The clinical success rates range from 55% to 80%, depending on the study and type of stent used. A recent clinical trial comparing stents to endoscopic valvulation showed that valvulation had a higher success rate and longer symptom-free survival than stents.<br /><br />Complications of stenting include stent migration, adherence to the bowel mucosa, perforation, and abdominal pain. Practical tips to avoid complications include careful patient selection, using fluoroscopy during the procedure, and advising patients on a specific diet and fluid intake.<br /><br />Despite the limited evidence, stenting can be a viable treatment option for IBD patients with stenosis refractory to other treatments. The choice of stent depends on the length and location of the stenosis. Future developments in stent design are needed to improve efficacy and minimize complications.

Asset Subtitle

Carme Loras Alastruey, MD, PhD

Keywords

endoscopic stenting

Crohn's disease

alternative to surgery

complications

inflammatory bowel disease