Endoscopic management of intestinal strictures in Crohn’s disease: Current status and future perspectives

Table 8 Selected key evidence studies on emerging/investigational endoscopic modalities for Crohn’s disease strictures

Modality	Ref.	Design	Patients/key details	Main outcomes	Complications	Notes/limitations
ESTx	Abreu et al[84], 2026	Systematic review	15 studies, 470 CD patients	Technical success 91.7%-100%; clinical success 71.4%-91%	Bleeding 5.2%-8.8%; perforation 0%-3.4%	Promising for short, fibrotic, anastomotic or EBD-refractory strictures
Intralesional corticosteroid injection	Di Nardo et al[95], 2010	RCT (pediatric)	29 pediatric CD patients	Reduced re-dilation and surgery vs placebo	No significant increase	Positive in children; conflicting adult data
Intralesional corticosteroid injection	East et al[96], 2007	RCT (adult)	13 adult patients (anastomotic CD stricture)	No benefit (trend toward worse outcome)	Similar to placebo	Small sample; no biologics used
Intralesional anti-TNF injection	Hendel et al[97], 2014	Prospective case series	6 CD patients (small bowel strictures)	Technical success; reduction in mSES-CD score	No adverse events	Larger RCTs needed
LAMS	Kankotia et al[99], 2024	Retrospective case series (LAMS vs EBD)	Benign lower GI strictures (including CD)	Technical success 100%; clinical success ~82% at > 6 months	No adverse events vs 17% with EBD	Equal efficacy vs EBD; trend towards fewer procedures with LAMS
LAMS	Yuksel et al[100], 2024	Case report	Combined ESt + LAMS	Technical success and short-term relief	None	Hybrid approach promising
LAMS	Manski and Schlachterman[101], 2023	Case report	Duodenal CD strictures	Technical success and short-term relief	None	Limited data; selective use in high operative risk patients
Image-guided hybrid technique	Pal et al[104], 2025	Case report (with IUS)	Hybrid ESt + EBD guided by intestinal US	Successful symptom relief	None	Precision approach; emerging
Biodegradable stents	Karstensen et al[102], 2016	Case series	6 CD cases	Technical success 83%, clinical success 20%	Migration, mucosal overgrowth, stent collapse	Highly investigational
Biodegradable stents	Rejchrt et al[103], 2011	Case series	11 CD patients	Technical success > 90%; rapid symptom relief but high early stent migration rates 28%	None	Highly investigational

ESTx: Endoscopic strictureplasty; CD: Crohn’s disease; EBD: Endoscopic balloon dilation; RCT: Randomized controlled trial; TNF: Tumor necrosis factor; mSES-CD: Modified Simple Endoscopic Score for Crohn’s Disease; LAMS: Lumen apposing metal stent; GI: Gastrointestinal; ESt: Endoscopic stricturotomy; IUS: Intestinal ultrasound.