Pros and cons of Danis stent application in esophageal bleeding

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Aim. A critical analysis of world clinical experience of endoscopic hemostasis with self-expanding nitinol Danis stents application in acute bleeding from esophageal varices.

Methods. Literature data of last 10 years about self-expanding nitinol Danis stents application at the peak of esophageal bleeding or in high risk of its recurrence were analyzed.

Results. The advantages of Danis stent include minimal injury, good tolerance by the patient, providing physiological drainage of saliva and the possibility of fluid and food intake through the mouth, possibility of a repeated endoscopic inspection of the esophagus and stomach after the application of the stent, reducing the risk of aspiration pneumonia, the impossibility of removal or displacement by the patient in agitation. According to most authors, Danis stent allows saving time to get ready for safe transjugular intrahepatic portocaval shunt (TIPS), surgical intervention or liver transplantation. This time should be used for performing all procedures necessary to stabilize the patient’s condition and clarify the nature of the existing pathology. Disadvantages include high risk of migration from the esophagus into the stomach with loss of its plugging function, limitation for treatment of only esophageal varices, development of small erosions or ulcers on the mucous membrane of the esophagus after removal of the stent. When Danis stent was used as a final method of treatment in patients who do not fit for TIPS or liver transplant, the mortality rate reached 50%.

Conclusion. To date, it is not yet clarified whether endoscopic hemostasis with self-expanding nitinol Danis stents should be firmly used in the treatment algorithm of patients with variceal bleeding; confirmation of initial clinical results in further comparative randomized controlled trials is necessary.

About the authors

A Yu Anisimov

Kazan State Medical Academy; City clinical hospital №7

Author for correspondence.

A V Loginov

City clinical hospital №7


A A Anisimov

Kazan State Medical University


M N Nasrullaev

Kazan State Medical Academy



  1. Горбашко А.И. Острые желудочно-кишечные кровотечения. Л.: Медицина. 1974; 250 с.
  2. Ерамишанцев А.К., Шерцингер А.Г., Киценко Е.А. Портальная гипертензия. Клиническая хирургия. Национальное руководство. М.: ГЭОТАР-Медиа. 2008; 626-665.
  3. Киценко Е.А., Анисимов А.Ю., Андреев А.И. Современное состояние проблемы кровотечений из варикозно расширенных вен пищевода и желудка. Вестн. соврем. клин. мед. 2014; 7 (5): 89-98.
  4. Трофимов Д.Н. Первый опыт использования самораскрывающихся металлических стентов SX-ELLA - Даниша для лечения кровотечения из варикозно расширенных вен пищевода. Семнадцатая Российская гастроэнтерологическая неделя. Всероссийская научно-практическая конференция «Актуальные вопросы эндоскопии 2011». (дата обращения: 15.05.2016).
  5. Шерцингер А.Г., Жигалова С.Б., Федотов Е.В. и др. Патогенез гастроэзофагеального кровотечения у больных декомпенсированным циррозом печени. Анн. хир. гепатол. 2008; 13 (2): 54-57.
  6. Шерцингер А.Г., Чжао А.В., Ивашкин В.Т. и др. Лечение кровотечений из варикозно расширенных вен пищевода и желудка. Анн. хир. гепатол. 2013; 18 (3): 110-129.
  7. Aabakken L. Endoscopic haemostasis. Best Pract. Res. Clin. Gastroenterol. 2008; 22 (5): 899-927.
  8. Bremholm L., Bendtsen F., Hansen E. Self-expanding metal stents for acute treatment of bleeding oesophageal varices. Endoscopy. 2009; 41 (1): A247.
  9. Bruha R., Drastich P., Fejfar T. et al. Guidelines on the diagnosis and treatment of bleeding into the digestive tract caused by portal hypertension. Gastroenterol. Hepatol. 2011; 65 (3): 141-142.
  10. Cardenas A. Management of acute variceal bleeding: emphasis on endoscopic therapy. Clin. Liver Dis. 2010; 14 (2): 251-262.
  11. Cook D., Laine L. Indications, technique and complications of balloon tamponade for variceal gastrointestinal bleeding. J. Intensive Care Med. 1992; 7: 212-218.
  12. D’Amico M., Berzigotti A., Garcia-Pagan J.C. Refractory acute variceal bleeding: what to do next? Clin. Liver Dis. 2010; 14 (2): 297-305.
  13. Dechene A., Adamzik M., Gerken G., Canbay A. Bronchial obstruction following esophageal stent implantation. Endoscopy. 2009; 41: El46-El47.
  14. Dechеne A., El Fouly A.H., Bechmann L.P. et al. Acute management of refractory variceal bleeding in liver cirrhosis by self-expanding metal stents. Digestion. 2012; 85 (3): 185-191.
  15. De Franchis R. Revising consensus in portal hypertension: report of the Bave- no V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J. Hepatol. 2010; 53 (4): 762-768.
  16. De Franchis R. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J. Hepatol. 2015; 63: 743-752.
  17. Didden P., Spaander M.C.W., Bruno M.J., Kuipers E.J. Esophageal stents in malignant and benign disorders. Curr. Gastroenterol. Rep. 2013; 15 (4): 319.
  18. Escorsell A., Bosch J. Self-expandable metal stents in the treatment of acute esophageal variceal bleeding. Gastroenterol. Res. Pr. 2011; 2011: 910986.
  19. Escorsell A., Cardenas A., Morillas R. et al. Self-expandable esophageal metal stent vs balloon tamponade in esophageal variceal bleeding refractory to medical and endoscopic treatment: A multicenter randomized controlled trial. Hepatology. 2013; 58: 36A-91A.
  20. Fejfar T., Hulek P., Jirkovsky V., Safka V. Pouiiti stentu v hepatologii. Zdr. Nov. 2012; 70-75.
  21. Fejfar T., Safka V., Jirkovsky V., Hulek P. Danis oesophageal stent in treatment of variceal bleeding. Gastroenterol. Hepatol. 2013; 67 (2): 98-103.
  22. Fierz F.C., Kistler W., Stenz V., Gubler C. Treatment of esophageal variceal hemorrhage with self-expanding metal stents as a rescue maneuver in a Swiss multicentric cohort. Case Reports Gastroenterol. 2013; 7 (1): 97-105.
  23. Frankova S., Sperl J., Stirad P. et al. Zavedeni samoexpandibilniho jicnoveho metalickeho stentu pro varikozni krvaceni - efektivni leeba pred transplantaci jater. Gastroenterol. Hepatol. 2011; 65 (1): 24.
  24. Garsia E. Protesis esofagica y hemorragia por varices. Hepatologia. 2012; 842: 23.
  25. Ghidirim G., Mishin L., Dolghii A. et al. Self-expanding metal stent for the management of bleeding esophageal varices - single center experience. HoBi Xipyprbmi TexHO/ioriT. 2012; 11 (4): 100-103.
  26. Herrlinger K. Classification and management of upper gastrointestinal bleeding. Internist. 2010; 51 (9): 1145-1156; quiz 1157.
  27. Holster I.L., Kuipers E.J., van Buuren H.R. et al. Self-expandable metal stents as definitive treatment for esophageal variceal bleeding. Endoscopy. 2013; 45 (6): 485-488.
  28. Hubmаnn R.G., Czompo M., Benko L. et al. Pouzitie ezofagoveho stentu - prve skusenosti v liecbe krvacajucich varixov pazeraka. Lekarsky. Obz. 2004; 53 (12): 458-461.
  29. Hubmann R., Bodlaj G., Czompo M. et al. The use of self-expanding metal stents to treat acute esophageal variceal bleeding. Endoscopy. 2006; 38 (9): 896-901.
  30. Matull W.-R., Cross T.J.S., Yu D. et al. A removable covered self-expanding metal stent for the management of Sengstaken-Blakemore tube-induced esophageal tear and variceal hemorrhage. Gastrointest. Endosc. 2008; 68 (4): 767-768; discussion 768.
  31. Maufa F., Al-Kawas F.H. Role of self-expandable metal stents in acute variceal bleeding. Int. J. Hepatol. 2012; 2012: 418369.
  32. Mishin I., Ghidirim G., Dolghii A. et al. Implantation of self-expanding metal stent in the treatment of severe bleeding from esophageal ulcer after endoscopic band ligation. Dis. Esophagus. Off J. Int. Soc. Dis. Esophagus. ISDE. 2010; 23 (7): E35-E38.
  33. O’Brien J., Triantos C., Burroughs A.K. Management of varices in patients with cirrhosis. Nat. Rev. Gastroenterol. Hepatol. 2013; 10 (7): 402-412.
  34. Peck-Radosavljevic M., Angermayr B., Datz C. et al. Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II). Wien. Klin. Wochenschr. 2013; 125 (7-8): 200-219.
  35. Rana S.S., Bhasin D.K. Gastrointestinal bleeding: from conventional to non-conventional! Endoscopy. 2008; 40 (1): 40-44.
  36. Rifai K. Acute-on-chronic liver failure. Eur. Gastroenterol. Hepatol. Rev. 2012; 8 (2): 111-115.
  37. Safka V., Hulek P. Current practice of Danis stent. Illustrations Josef Bavor. Lithography and cover design Olga Cemakova. Print H.R.G. Litomysl. 2014; 136 p.
  38. Sauerbruch T., Appenrodt B., Schmitz V., Spengler U. The conservative and interventional treatment of the complications of liver cirrhosis: Part 2 of a series on liver cirrhosis. Dtsch. Arzteblatt. Int. 2013; 110 (8): 126-132.
  39. Weismuller T.J., Manns M.P., Wedemeyer J. Varizenblutung. Intensiv. Notfall. Med. 2010; 47 (8): 559-564.
  40. Wong Kee Song L.-M., Banerjee S., Barth B.A. et al. Emerging technologies for endoscopic hemostasis. Gastrointest. Endosc. 2012; 75 (5): 933-937.
  41. Wright G., Lewis H., Hogan B. et al. A self-expanding metal stent for complicated variceal hemorrhage: experience at a single center. Gastrointest. Endosc. 2010; 71 (1): 71-78.
  42. Zakaria M.S., Hamza I.M., Mohey M.A., Hubamnn R.G. The first Egyptian experience using new self-expandable metal stents in acute esophageal variceal bleeding: pilot study. Saudi J. Gastroenterol. Off. Saudi Gastroenterol. Assoc. 2013; 19 (4): 177-181.
  43. Zehetner J., Shamiyeh A., Wayand W., Hubmann R. Results of a new method to stop acute bleeding from esophageal varices: implantation of a self-expanding stent. Surg. Endosc. 2008; 22 (10): 2149-2152.

© 2016 Anisimov A.Y., Loginov A.V., Anisimov A.A., Nasrullaev M.N.

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