title: Endoscopic treatment with self-expanding metal stents for Crohn’s disease strictures.
abstract: BACKGROUND
  Balloon dilation (with or without steroid injection) is the endoscopic treatment of choice for short strictures in Crohn's disease (CD). The placement of a stent has only rarely been reported in this setting, and it may be a good alternative.
  
  
  OBJECTIVE
  To describe the efficacy of temporary placement of a self-expanding metallic stent (SEMS) in the endoscopic treatment of symptomatic strictures in CD.
  
  
  METHODS
  We included 17 CD patients treated with SEMS (4 partially covered SEMS and 21 fully covered SEMS) for symptomatic strictures refractory to medical and/or endoscopic treatment.
  
  
  RESULTS
  We placed 25 stents in 17 patients with stenosis (<8 cm), in the colon and in the ileocolonic anastomosis. In two cases, two stents were placed in the same endoscopic procedure. All except three cases had previously been unsuccessfully treated with endoscopic dilatation. The stents were maintained for an average of 28 days (1–112). The treatment was effective in 64.7% of the patients after a mean follow-up time of 60 weeks (5–266). In four cases, removal of the stents was technically difficult due to stent impaction (moderate adverse events-AEs) and one patient had a proximal stent migration requiring delayed surgery (severe AE).
  
  
  CONCLUSIONS
  The placement of self-expanding metallic stent in Crohn's disease maintained over a period of 4 weeks is a safe, effective treatment for strictures refractory to medical treatment and/or balloon dilatation, and might be an alternative endoscopic
authors.affiliation: Department of Gastroenterology, Endoscopy Unit, Hospital Universitari Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, Terrassa, Catalonia, Spain. cloras76@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Loras
authors.forename: F
authors.initials: F
authors.lastname: Pérez-Roldan
authors.forename: J B
authors.initials: JB
authors.lastname: Gornals
authors.forename: J
authors.initials: J
authors.lastname: Barrio
authors.forename: F
authors.initials: F
authors.lastname: Igea
authors.forename: F
authors.initials: F
authors.lastname: González-Huix
authors.forename: P
authors.initials: P
authors.lastname: González-Carro
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Miranda
authors.forename: J C
authors.initials: JC
authors.lastname: Espinós
authors.forename: F
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: M
authors.initials: M
authors.lastname: Esteve
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008670:Metals