title: Endoscopic Stenting With the Over-The-Scope Technique: Our Experience With 11 Consecutive Patients.
abstract: BACKGROUND
  Endoscopic stenting is widely used to manage benign and malignant strictures, postoperative stenoses, or anastomotic leaks and fistulas.
  
  
  METHODS
  However, Over the Wire delivery systems are generally short and quite stiff, and therefore, cannot reach distal parts of the gastrointestinal tract or cross severely angulated strictures. In such cases, we used the Over-the-Scope stenting (OTSS) technique to deliver and deploy endoscopically large-bore fully covered stents. We present herein a series of 11 patients treated with the OTSS technique for a variety of indications. To our knowledge, this is the largest series of OTSS cases published.
  
  
  RESULTS
  The stents were correctly deployed in 10 cases. In one case, the stent was dislocated during scope withdrawal and Through the Scope stenting was performed with a smaller diameter uncovered stent instead. Predilation of the stricture was necessary in 5 patients. Clinical success was achieved in all patients.
  
  
  CONCLUSIONS
  Our results encourage the use of the OTSS technique in cases where standard Over the Wire delivery systems of large-bore stents cannot reach or cross distal or tortuous strictures. The technique can also be used to reinsert migrated stents or misplaced braided-suture release mechanism (Ultraflex) stents.
authors.affiliation: *Digestive and Interventional Endoscopy Unit, Niguarda Ca' Granda Hospital, Milan, Italy †Endoscopy Department, St Lukes Hospital, Thessaloniki, Greece.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mutignani
authors.forename: Stefanos
authors.initials: S
authors.lastname: Dokas
authors.forename: Edoardo
authors.initials: E
authors.lastname: Forti
authors.forename: Francesco
authors.initials: F
authors.lastname: Pugliese
authors.forename: Raffaele
authors.initials: R
authors.lastname: Manta
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Dioscoridi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000517:prevention & control*; D003251:Constriction, Pathologic / Q000601:surgery; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome