Malignant esophageal strictures: treatment with a self-expanding nitinol stent.

Abstract

A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent tumor bleeding occurred in two patients, and ingrowth of tumor into the stent was seen in eight patients. Two stents occluded due to tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (range, 0.1-7.0 months), and 12 patients were alive with a mean follow-up of 8.8 months (range, 4.0-15.0 months).

Self-Expanding Nitinol Stent for Malignant Obstructive Dysphagia–Initial Experience

“…Procedure-related mortality was low (3%) and significant morbidity also low (one transient melena and one partial stent migration -6%). This compares well with the series of Cwikiel et al 7 in which one patient of 40 died three days after stenting, and the series of Raijman et al 8 in which two patients of 14 died one and six days respectively after the procedure, one from aspiration pneumonia and the other from myocardial infarction.…”

“…In 1990, Domschke et al reported the first small series of self-expanding metal mesh stents 6 and in 1993, Wojciech Cwikiel et al published a large series of successful implantations of self-expanding nitinol mesh stents in 40 patients. 7 This paper describes our initial experience with the nitinol stent.…”

Palliative treatment of obstructing esophageal cancer with nitinol stents: value, safety, and long-term results.

“…[4, [26][27][28][29]. One patient had a single hematemesis withoutfurther problems [28], one stent migrated [29], and two were placed incorrectly [30].…”

Palliative Treatment of Malignant Inoperable Esophageal Strictures with Self-Expandable Metallic Stents: Single Center Experience with 155 Patients

“…Dyspha gi a was gra ded on a sca le of 0 to 4 ac cording to Cwi ki el et al 5 Pa ti ents we re gra ded twi ce prior to the stent de li very and af ter the pro ce du re:…”