A research article to be published on 28 June 2008, in the World Journal of Gastroenterology addressed this question. The research team led by Prof. Serhat Aymaz from Cologne City Hospital presented a new type of stent design for transcardial application, which is intended to prevent bleeding due to mechanical mucosal lesions caused by the distal end of the stent extending into the stomach.
They decided to carry out palliative stent implantation to treat the stenosis. As transcardially positioned stents are associated with higher complication rates and experience shows that bleeding often occurs due to stent-related mucosal lesions in the stomach, they requested individual production of an unusually shaped self-expanding nitinol stent (SEMS). The stent was woven from nitinol in accordance with our specifications and was 140 mm long and 24 mm wide. The distal end of the stent was to bend cranially to ensure that the stent would fit the cardia and would not extend freely into the stomach. With the exception of the uncovered proximal bulb, the stent was completely covered. The stent was placed on a carrier system with a diameter of 8 mm and was released in the conventional way from the distal end after partially releasing the umbrella-like end and pulling the stent until the distal end fitted the cardia tightly. The stent was positioned without any special difficulties in conventional way. The early clinical result was good after 24 h. The radiographic, clinical and endoscopic follow-up during a 4-mo period showed that the stent was still correctly positioned and none of usual complications occurred.
The Physicians believe that the availability of individual stent production should be taken advantage of much more frequently and that individual stent designing could alleviate many of the late complications associated with stent treatment.