title: Safety and efficacy of extractible self-expandable metal stents in the treatment of Crohn's disease intestinal strictures: a prospective pilot study.
abstract: BACKGROUND
  Endoscopic management of Crohn's disease (CD) intestinal strictures with balloon dilation is effective; however, recurrences are frequent and require further dilations or surgery. The use of extractible metallic stents may be as effective as balloon dilation with fewer recurrences. The aim was to investigate in a prospective pilot study the feasibility and clinical effectiveness of the use of extractible stents in the treatment of CD intestinal strictures.
  
  
  METHODS
  In two tertiary referral centers, quiescent CD patients except for obstructive symptoms associated with intestinal stenosis of less than 50 mm length on enterography were eligible for transitory stent placement, initially planned to be retrieved after 8 weeks, which was secondarily reduced to 4 weeks after patient 3.
  
  
  RESULTS
  Eleven patients (six males, five females, median age 34 years [range 18-66]) were prospectively included. The sites of intestinal stenosis were an ileocolonic anastomosis, an ileosigmoidic anastomosis, and the surgically untreated terminal ileum in eight, one, and two patients, respectively. Stent placement was technically successful in 10 patients. Obstructive symptoms were relieved in 6 out of 10 patients. Two patients needed surgery related to the procedure. Six downstream migrations were observed. Only one patient could have the stent extracted as scheduled on day 28 and remains symptom-free after 73 months of follow-up.
  
  
  CONCLUSIONS
  Even if stenting appears an effective technique in treating symptomatic CD intestinal strictures, the procedure is associated with a prohibitively high rate of spontaneous migrations and complications.
authors.affiliation: Service de Gastro-Entérologie, MICI, Assistance Nutritive, Hôpital Beaujon, Clichy, France. alain.attar@bjn.aphp.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Attar
authors.forename: Vincent
authors.initials: V
authors.lastname: Maunoury
authors.forename: Kouroche
authors.initials: K
authors.lastname: Vahedi
authors.forename: Gwennola
authors.initials: G
authors.lastname: Vernier-Massouille
authors.forename: Setakhr
authors.initials: S
authors.lastname: Vida
authors.forename: Philippe
authors.initials: P
authors.lastname: Bulois
authors.forename: Jean Frédéric
authors.initials: JF
authors.lastname: Colombel
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization; D002648:Child; D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D012449:Safety; D055502:Secondary Prevention; D015607:Stents; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D008670:Metals