Innovative device for low-trauma installation and extraction of the monospiral esophageal stent
Authors: Sayapin S.N.
Published in issue: #10(166)/2025
DOI: 10.18698/2308-6033-2025-10-2479
Category: Mechanics | Chapter: Biomechanics and Bioengineering
Treatment of acute bleeding from the esophageal varices remains a complex problem. Solving it requires development of the new efficient methods and minimally invasive instruments. These include, first and foremost, the methods and instruments for the minimally invasive insertion and removal of elastic monospirals and superelastic self-expanding polyspiral nitinol Danis stents. These stents offer several advantages compared to the common method of the esophageal varices balloon tamponade using the inflatable Sengstaken—Blakemore obturator. The paper presents a comparative analysis of the monospiral and polyspiral compression methods for the esophageal bleeding arrest, and reveals a common drawback associated with the risk of potential injury to the esophageal varices during the stent insertion and removal. To address this drawback, the paper proposes an innovative device for the minimally invasive insertion and retrieval of a monospiral esophageal stent with the controllably deployable and retractable superelastic monocrystalline coil made of the Cu–Al–Ni alloy. It provides an example of implementation of the superelastic monospiral compression on the esophageal simulator.
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References
[1] Nazyrov F.G., Devyatov A.V., Babadzhanov A.H., Dzhumaniyazov D.A., Baybekov R.R. Effektivnost endoskopicheskikh vmeshatelstv v profilaktike krovotecheniy portalnogo geneza [Efficacy of endoscopic intervention in the prevention of portal genesis bleedings]. Vestnik eksperimentalnoy i klinicheskoy khirurgii — Journal of Experimental and Clinical Surgery, 2017, vol. 10 (3), pp. 187–194.
[2] Sayapin S.N., Nazyrov F.G., Devyatov A.V., Sokolova A.S. Analiz sostoyaniya i perspektivy razvitiya transformiruemykh zondov dlya ostanovki krovotecheniy iz varikozno-rasshirennykh ven pishchevoda [Treatment of esophageal varices bleeding with the use of transformable probes]. Khirurgiya. Zhurnal im. N.I. Pirogova — Pirogov Russian Journal of Surgery, 2010, no. 12, pp. 58–64.
[3] Kovach T.O.G., Jensen D.M. Recent advances in the endoscopic diagnosis and therapy of upper gastrointestinal, small intestinal and colonic bleeding. Med. Clin. North Am., 2002, vol. 86 (6), pp. 1319–1356.
[4] Caldwell S.H., Shami V.M., Hespenheide E.E. Injection therapy of esophageal and gastric varices: sclerosis and cyanoacrylate. In: Drossman D.A. (Senior ed.). Handbook of Gastroenterologic Procedures, 4th ed. Lippincott Williams & Wilkins, Philadelphia, 2008, pp. 103–111.
[5] Carvalho E., Nita M.H., Paiva L.M.A., Silva A.A.R. Hemorragia digestive. Journal de Pediatria, 2000, vol. 76 (Supl 2), pp. 135–146.
[6] Isaacs K.L. Balloon Tamponade. In: Drossman D.A. (Senior ed.). Handbook of Gastroenterologic Procedures. 4th ed. Lippincott Williams & Wilkins, Philadelphia, 2008, pp. 119–126.
[7] Shertsinger A.G. Lechenie krovotecheniy iz varikozno-rasshirennykh ven pishchevoda zondom obturatorom [Treatment of bleeding from varicose veins of the esophagus with an obturator probe]. Khirurgiya, 1980, no. 3, pp. 94–98.
[8] Nazyrov F.G., Devyatov A.V. (SSSR). Sposob ostanovki krovotecheniya iz varikozno-rashirennykh ven pishchevoda [Method to stop bleeding from varicose veins of the esophagus]. A.s. 1362462 USSR, publ. 30.12.87, bull. no. 48, 3 p.
[9] Currais P., Nunes G., Palita M. et al. SX-ELLA Danis-Stent for Refractory Acute Esophageal Variceal. GE Port J Gastroenterol, 2023, no. 30, pp. 162–165.
[10] Loginov A.V., Mamkeev EH.H., Anisimov A.YU. Samorasshiryayushchiysya nitinolovyi stent v konpleksnom lechenii bolnykh s krovotecheniyami iz varikozno-rasshirennykh ven pishchevoda [Self-expanding nitinol stent in combined treatment of bleeding from esophageal varices]. Kazanskiy meditsinskiy zhurnal — Kazan Medical Journal, 2016, vol. 97, no. 5, pp. 801–805.
[11] Anisimov A.Yu., Loginov A.V., Ibragimov A.A., Anisimov A.A. Endoskopicheskiy gemostaz samorashiryayushchimisya nitinolovymi stentami (obzor literatury) [Endoscopic hemostasis with self-expanding nitinol stents (literature review)]. Annaly khirurgicheskoy gepatologii — Annals of HPB Surgery, 2020, vol. 25, no. 1, pp. 24–105.
[12] Anisimov A.Yu., Loginov A.V. Stent Danisha pri pishchevodnom krovotechenii: za i protiv [Danis stent for esophageal bleeding: for and against]. Prakticheskaya meditsina — Practical Medicine, 2016, no. 5 (97), pp. 58–66.
[13] Kraev A.V. Anatomiya cheloveka: v 2 kn. [Human anatomy: in 2 books]. Moscow, Meditsina Publ., 2007, vol. 1, 552 p.
[14] Antonov P.I., Kosilov A.T., Vasilenko A.YU., Kandybin V.I. Poluchenie i svoystva profilirovannykh monokristallov Cu-Al-Ni [Preparation and properties of the profiled Cu-Al-Ni monocrystals]. Izvestiya Akademii nauk SSSR. Seriya fizicheskaya — Bulletin of the Russian Academy of Sciences: Physics, 1980, vol. 44, no. 2, pp. 404–408.
[15] Tikhonov A.S., Gerasimov A.P., Prokhorova I.I. Primenenie effekta pamyati formy v sovremennom mashinostroenii [Application of the shape memory effect in modern mechanical engineering]. Moscow, Mashinostroenie Publ., 1981, 81 p.
[16] Komarov S.M., Lukyanychev S.Yu. Nitinol — podatlivyi, no vse pomnyashchiy [Nitinol is malleable, but it remembers everything]. Khimiya i zhizn — Chemistry and Life, 1998, no. 3, pp. 40–42.
[17] Sayapin S.N., Nazyrov F.G., Devyatov A.V., Sayapina A.S. Sposob ostanovki krovotecheniy iz varikozno-rasshirennykh ven pishchevoda i transformiruemyi zond dlya ego osushchestvleniya [Method for stopping bleeding from varicose veins of the esophagus and a transformable probe for its implementation]. Patent no. 2316272 Russian Federation, 2008, bull. no. 4, 13 p.
[18] Yangurazov A.Kh. Naznachenie endoskopov: vidy gastroendoskopov, sovremennaya klassifikatsiya gastroskopov [Purpose of endoscopes: types of gastroendoscopes, modern classification of gastroscopes]. Vestnik magistratury — Magister Journal, 2019, no. 6–4 (93), pp. 41–45.