Polymeric endoesophageal paving: A biodegradable alternative to stenting

Marvin J Slepian, M. S. Mokhashi, B. Dehdashti, R. E. Sampliner

Research output: Contribution to journalArticle

Abstract

Background: Metallic endoesophageal stents suffer from the limitations of migration, removal difficulty, chronic injury and restenosis. An improvement over current stents would be a method which would provide structural integrity without the liability of a permanent implant. We developed a new technique in which biodegradable polymers could be deployed within a tissue lumen and locally thermoformed to yield an adherent, supporting, custom-contoured endoluminal liner. Aim: In this study we examined the feasibility and acute efficacy of in situ catheter-based thermoforming of biodegradable polymers on the endoluminal surface of freshly explanted porcine esophagi. Methods: Porcine esophagi (n - 6) were mounted in a physiologic organ bath and an endoluminal mucosal tear was induced via passage of a stiff wire. Baseline fiberoptic endoscopy and intraluminal ultrasound was performed. A balloon tipped catheter allowing for controlled mechanical and thermal deformation facilitated polymer application (6 atm, 60° C., 15 sec.). A 55mm × 20mm sheet of polymer covering the catheter balloon was placed in mid-esophagus over the tear, the balloon dilated and heated (4 atm, 63° C.) and the sheet thermoformed on the endoesophageal surface (paving). Repeat endoscopy and ultrasound was performed to examine esophageal integrity and conformity of the polymer layer to the esophageal surface. Results: In all esophagi studied, in situ thermoforming was achieved with esophageal segments being lined with a continuous layer of polymer as a conformal film. In all segments endoluminal polymer was found to readily flow over and seal tears, conforming to surface irregularities. Conclusion: In situ thermoforming of biodegradable structural polymers is feasible yielding an effective endoluminal wall support. Further development of this approach may yield a versatile biodegradable method of providing support.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume47
Issue number4
StatePublished - 1998

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Polymers
Esophagus
Tears
Catheters
Endoscopy
Stents
Swine
Feasibility Studies
Baths
Hot Temperature
Wounds and Injuries

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Polymeric endoesophageal paving : A biodegradable alternative to stenting. / Slepian, Marvin J; Mokhashi, M. S.; Dehdashti, B.; Sampliner, R. E.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 1998.

Research output: Contribution to journalArticle

Slepian, Marvin J ; Mokhashi, M. S. ; Dehdashti, B. ; Sampliner, R. E. / Polymeric endoesophageal paving : A biodegradable alternative to stenting. In: Gastrointestinal Endoscopy. 1998 ; Vol. 47, No. 4.
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