New Metallic Ureteral Stents: Improved Tensile Strength and Resistance to Extrinsic Compression

Background and Purpose: Extrinsic ureteral compression challenges a ureteral stent's ability to facilitate urinary drainage and to protect the kidney. Our purpose was to evaluate the performance of new metallic coil-based ureteral stents in terms of tensile strength and radial compression force. Materials and Methods: Three stent designs tested from Prosurg Inc included Passage 7.0F, Snake 6.0F, and Snake 7.0F with the straight section covered with a biocompatible polymer tubing. A MTS Microbionix Testing System using Testworks II software, vibration isolation table, and a 5-N load cell were used to measure tensile and compressive strength. Stents were placed in hydraulic grips and stretched at a rate of 5 mm/s for 1 second under uniaxial tension. Extrinsic compression was exerted in 0.1-mm increments to maximum compression. The Young Modulus, E, was calculated from each trial using engineering stress. Data were analyzed using Mann-Whitney and t tests. Results: The Passage, Snake 6F, and Snake 7F stents had tensile strengths of 27 +/- 3, 5 +/- 0.1, and 73 +/- 26 kPa, respectively. Mann-Whitney tests show statistically significant difference between stents (P < 0.05). Elastic modulus needed to cause extrinsic compression was highest for Snake 6F (145,842 +/- 14332 Pa) compared with that of Passage (124,999 +/- 3182 Pa) and Snake 7F (126,132 +/- 19316 Pa), (P < 0.05). Conclusion: The Snake 6F stent had the lowest tensile strength and was least resistant to extrinsic compression. The Snake 7F had the highest tensile strength and was most resistant to extrinsic compression. All three stents are more resistant to extrinsic compression than the Applied Silhouette or Cook Resonance, yet have lower tensile strengths.