Stent

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For people named Stent, see Stent (surname).
Endoscopic image of biliary stent seen protruding from ampulla of Vater at the time of duodenoscopy
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Endoscopic image of biliary stent seen protruding from ampulla of Vater at the time of duodenoscopy

In medicine, a stent is either an expandable wire form or perforated tube (conventionally perforated by means of laser cutting) that is inserted into a natural conduit of the body to prevent or counteract a disease-induced localized flow constriction.

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[edit] Applications

The main purpose of a stent is to counteract significant decreases in vessel or duct diameter. Stents are often used to alleviate diminished blood flow to organs beyond an obstruction in order to maintain an adequate delivery of oxygen. Although the most common use of stents is in coronary arteries, they are widely used in other tubular structures, such as central and peripheral arteries and veins, bile ducts, oesophagus, colon, trachea or large bronchi, ureters, and urethra.

[edit] Problems

One of the drawbacks of vascular stents is the potential development of a thick smooth muscle tissue inside the lumen, the so-called neointima. Development of a neointima is variable but can at times be so severe as to re-occlude the vessel lumen (restenosis), especially in the case of smaller diameter vessels, which often results in reintervention. Consequently, current research focuses on the reduction of neointima after stent placement. Considerable improvements have been made, including the use of more bio-compatible materials, anti-inflammatory drug-eluting stents, resorbable stents, and others. Fortunately, even if stents are eventually covered by neointima, the minimally invasive nature of their deployment makes reintervention possible and usually straightforward.

[edit] Etymology

The origin of the word stent remains unsettled. The verb stenting was used for centuries for the process of stiffening garments (a usage long obsolete, per the OED) and some believe this to be the origin. Others attribute the noun stent to Jan F. Esser, a Dutch plastic surgeon who in 1916 used the word to describe a dental impression compound invented in 1856 by the English dentist Charles Stent (18071885), which Esser employed to craft a form for facial reconstruction. The full account is described in the Journal of the History of Dentistry. [1] According to the author, from the use of Stent's compound as support for facial tissues grew the eventual use of stent to open various bodily structures.

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