Comparison of 316 fully-covered stent placements without fixation, with endoscopic suturing and with stentfix OTSC® shows stentfix offers a cost-effective solution with low stent migration rate

We would like to inform you about a recent retrospective multicentre review by Mehta et al. (2024):

Key findings

• Stent fixation with stentfix OTSC® (SF) led to decreased risk of stent migration (SF: 17%, endoscopic suturing (ES) 24% and no fixation (NF) 39%) (SF vs NF, p=0.001 ES vs NF, p=0.01 and SF vs ES, p=0.2)

• Median time to stent migration was significantly longer for the SF group than for the NF group (38 days compared to 24 days, p=0.04)

• Fixation with stentfix OTSC® was associated with higher rates of clinical success compared to NF (68% vs 52%, p=0.03)

• Mean procedure time with stentfix OTSC® was 66 minutes, compared to 41 minutes with NF and 79.5 minutes for ES

• stentfix OTSC® offers significant cost benefits over endoscopic suturing, with a lower system price in the US and simpler removal using rat-tooth forceps instead of endoscopic scissors.

Study details

• 311 patients underwent 316 stenting procedures for benign indications in the upper GI tract (mean age 60, 49.5% male)

• 122 underwent no fixation, 94 stent fixation with stentfix OTSC® and 95 with endoscopic suturing

• A single clip was used in all cases of stent fixation with stentfix OTSC®

• Stent placement was performed for benign strictures (56%), leaks, fistulas, and perforations (43%) and refractory variceal bleeding (0.6%)

Mehta A, Ashhab A, Shrigiriwar A, Assefa R, Canakis A, Frohlinger M, Bouvette CA, Matus G, Punkenhofer P, Mandarino FV, Azzolini F, Samaan JS, Advani R, Desai SK, Confer B, Sangwan VK, Pineda-Bonilla JJ, Lee DP, Modi K, Eke C, Schiemer M, Rondini E, Dolak W, Agarunov E, Duku M, Telese A, Pawa R, Pawa S, Velasco NZ, Farha J, Berrien-Lopez R, Abu S, McLean-Powell CK, Kim RE, Rumman A, Spaun GO, Arcidiacono PG, Park KH, Khara HS, Diehl DL, Kedia P, Kuellmer A, Manta R, Gonda TA, Sehgal V, Haidry R, Khashab MA. Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expanding metal stents in benign upper gastrointestinal conditions: a comparative multicenter international study (With Video). Gastrointest Endosc. Published online 2024, August 22. DOI: 10.1016/j.gie.2024.08.015