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Reducing deposition of encrustation in ureteric stents by changing the stent architecture: a microfluidic-based investigation

Reducing deposition of encrustation in ureteric stents by changing the stent architecture: a microfluidic-based investigation
Reducing deposition of encrustation in ureteric stents by changing the stent architecture: a microfluidic-based investigation
Ureteric stents are clinically deployed to retain ureteral patency in the presence of an obstruction of the ureter lumen. Despite the fact that multiple stent designs have been researched in recent years, encrustation and biofilm-associated infections remain significant complications of ureteral stenting, potentially leading to the functional failure of the stent. It has been suggested that ‘inactive’ side-holes of stents may act as anchoring sites for encrusting crystals, as they are associated with low wall shear stress (WSS) levels. Obstruction of side-holes due to encrustation is particularly detrimental to the function of the stent, since holes provide a path for urine to by-pass the occlusion. Therefore, there is an unmet need to develop novel stents to reduce deposition of encrusting particles at side-holes. In this study, we employed a stent-on-chip (SoC) microfluidic model of the stented and occluded ureter to investigate the effect of stent architecture on WSS distribution and encrustation over its surface. Variations in the stent geometry encompassed (i) the wall thickness and (ii) the shape of side-holes. Stent thickness was varied in the range 0.3-0.7 mm, while streamlined side-holes of triangular shape were evaluated (with vertex angle in the range 45-120°). Reducing the thickness of the stent increased WSS and thus reduced encrustation rate at side-holes. A further improvement in performance was achieved by using side-holes with triangular shape; notably, a 45° vertex angle showed superior performance compared to other angles investigated, resulting in a significant increase in WSS within ‘inactive’ side-holes. In conclusion, by combining the optimal stent thickness (0.3 mm) and hole vertex angle (45°) resulted in a ~90% reduction in encrustation rate within side-holes, compared to a standard design. If translated to a full-scale ureteric stent, this optimised architecture has the potential for significantly increasing the stent lifetime while reducing clinical complications.
1932-1058
1-15
Mosayyebi, Ali
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Lange, Dirk
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Yue, Qi Yann
fa887406-7e2a-4abb-9dad-5ebb5723a610
Somani, Bhaskar
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Zhang, Xunli
d7cf1181-3276-4da1-9150-e212b333abb1
Manes, Costantino
7d9d5123-4d1b-4760-beff-d82fe0bd0acf
Carugo, Dario
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Mosayyebi, Ali
ab9cf6da-58c4-4441-993b-7d03d5d3549a
Lange, Dirk
7c95635d-eda7-4f7a-8634-98cff0746c81
Yue, Qi Yann
fa887406-7e2a-4abb-9dad-5ebb5723a610
Somani, Bhaskar
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Zhang, Xunli
d7cf1181-3276-4da1-9150-e212b333abb1
Manes, Costantino
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Carugo, Dario
0a4be6cd-e309-4ed8-a620-20256ce01179

Mosayyebi, Ali, Lange, Dirk, Yue, Qi Yann, Somani, Bhaskar, Zhang, Xunli, Manes, Costantino and Carugo, Dario (2019) Reducing deposition of encrustation in ureteric stents by changing the stent architecture: a microfluidic-based investigation. Biomicrofluidics, 13 (1), 1-15, [014101]. (doi:10.1063/1.5059370).

Record type: Article

Abstract

Ureteric stents are clinically deployed to retain ureteral patency in the presence of an obstruction of the ureter lumen. Despite the fact that multiple stent designs have been researched in recent years, encrustation and biofilm-associated infections remain significant complications of ureteral stenting, potentially leading to the functional failure of the stent. It has been suggested that ‘inactive’ side-holes of stents may act as anchoring sites for encrusting crystals, as they are associated with low wall shear stress (WSS) levels. Obstruction of side-holes due to encrustation is particularly detrimental to the function of the stent, since holes provide a path for urine to by-pass the occlusion. Therefore, there is an unmet need to develop novel stents to reduce deposition of encrusting particles at side-holes. In this study, we employed a stent-on-chip (SoC) microfluidic model of the stented and occluded ureter to investigate the effect of stent architecture on WSS distribution and encrustation over its surface. Variations in the stent geometry encompassed (i) the wall thickness and (ii) the shape of side-holes. Stent thickness was varied in the range 0.3-0.7 mm, while streamlined side-holes of triangular shape were evaluated (with vertex angle in the range 45-120°). Reducing the thickness of the stent increased WSS and thus reduced encrustation rate at side-holes. A further improvement in performance was achieved by using side-holes with triangular shape; notably, a 45° vertex angle showed superior performance compared to other angles investigated, resulting in a significant increase in WSS within ‘inactive’ side-holes. In conclusion, by combining the optimal stent thickness (0.3 mm) and hole vertex angle (45°) resulted in a ~90% reduction in encrustation rate within side-holes, compared to a standard design. If translated to a full-scale ureteric stent, this optimised architecture has the potential for significantly increasing the stent lifetime while reducing clinical complications.

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A Mosayyebi Biomicrofluidics Sept 2018 final - Accepted Manuscript
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1.5059370 - Version of Record
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More information

Accepted/In Press date: 18 December 2018
e-pub ahead of print date: 4 January 2019
Published date: January 2019

Identifiers

Local EPrints ID: 426955
URI: http://eprints.soton.ac.uk/id/eprint/426955
ISSN: 1932-1058
PURE UUID: 806449e1-d736-481c-851f-9e73b3781e2d
ORCID for Xunli Zhang: ORCID iD orcid.org/0000-0002-4375-1571

Catalogue record

Date deposited: 19 Dec 2018 17:30
Last modified: 26 Nov 2021 06:10

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Contributors

Author: Ali Mosayyebi
Author: Dirk Lange
Author: Qi Yann Yue
Author: Bhaskar Somani
Author: Xunli Zhang ORCID iD
Author: Costantino Manes
Author: Dario Carugo

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