Efficacy and safety of a new fully covered self-expandable non-foreshortening metal esophageal stent

Kulwinder S. Dua, Sahibzada U. Latif, Juliana Yang, Tom C. Fang, Abdul Khan, Young Oh

Research output: Contribution to journalArticle

Abstract

Background: Fully covered esophageal self-expandable metal stents (SEMSs) are potentially removable but can be associated with high migration rates. For precise positioning, non-foreshortening SEMSs are preferred. Recently, a new fully covered non-foreshortening SEMS with anti-migration features was introduced. Objective: To evaluate the efficacy and safety of this new esophageal SEMS. Design: Retrospective study. Setting: Single, tertiary-care center. Patients: Consecutive patients with malignant and benign strictures with dysphagia grade of R3 and patients with fistulas/leaks were studied. Interventions: Stent placement and removal. Main Outcome Measurements: Technical success in stent deployment/removal, efficacy in relieving dysphagia and sealing fistulas/leaks, and adverse events. Results: Forty-three stents were placed in 35 patients (mean [± standard deviation] age 65 ± 11 years; 31 male), 24 for malignant and 11 for benign (5 strictures, 6 leaks) indications. Technical success in precise SEMS placement was 100%. The after-stent dysphagia grade improved significantly (at 1 week: 1.5 ± 0.7; at 4 weeks: 1.2 ± 0.4; baseline: 3.8 ± 0.4; P< .0001). Twenty stents were removed for clinical indications, with technical success of 100%. All leaks sealed after SEMS placement and did not recur after stent removal. All benign strictures recurred after stent removal. Adverse events included migration (14%), chest pain (11%), and dysphagia from tissue hyperplasia (6%). There was no stent-related mortality. Limitations: Nonrandomized, single-center study. Conclusion: The new esophageal SEMS was effective in relieving malignant dysphagia, allowed for precise placement, and was easily removable. It was effective in treating benign esophageal fistulas and leaks. Stent-related adverse events were acceptable.

Original languageEnglish (US)
Pages (from-to)577-585
Number of pages9
JournalGastrointestinal Endoscopy
Volume80
Issue number4
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Stents
Metals
Safety
Deglutition Disorders
Pathologic Constriction
Fistula
Esophageal Fistula
Self Expandable Metallic Stents
Chest Pain
Tertiary Care Centers
Hyperplasia
Retrospective Studies
Mortality

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Efficacy and safety of a new fully covered self-expandable non-foreshortening metal esophageal stent. / Dua, Kulwinder S.; Latif, Sahibzada U.; Yang, Juliana; Fang, Tom C.; Khan, Abdul; Oh, Young.

In: Gastrointestinal Endoscopy, Vol. 80, No. 4, 01.10.2014, p. 577-585.

Research output: Contribution to journalArticle

Dua, Kulwinder S. ; Latif, Sahibzada U. ; Yang, Juliana ; Fang, Tom C. ; Khan, Abdul ; Oh, Young. / Efficacy and safety of a new fully covered self-expandable non-foreshortening metal esophageal stent. In: Gastrointestinal Endoscopy. 2014 ; Vol. 80, No. 4. pp. 577-585.
@article{752860a12b834b7e8166935443e7b2d2,
title = "Efficacy and safety of a new fully covered self-expandable non-foreshortening metal esophageal stent",
abstract = "Background: Fully covered esophageal self-expandable metal stents (SEMSs) are potentially removable but can be associated with high migration rates. For precise positioning, non-foreshortening SEMSs are preferred. Recently, a new fully covered non-foreshortening SEMS with anti-migration features was introduced. Objective: To evaluate the efficacy and safety of this new esophageal SEMS. Design: Retrospective study. Setting: Single, tertiary-care center. Patients: Consecutive patients with malignant and benign strictures with dysphagia grade of R3 and patients with fistulas/leaks were studied. Interventions: Stent placement and removal. Main Outcome Measurements: Technical success in stent deployment/removal, efficacy in relieving dysphagia and sealing fistulas/leaks, and adverse events. Results: Forty-three stents were placed in 35 patients (mean [± standard deviation] age 65 ± 11 years; 31 male), 24 for malignant and 11 for benign (5 strictures, 6 leaks) indications. Technical success in precise SEMS placement was 100{\%}. The after-stent dysphagia grade improved significantly (at 1 week: 1.5 ± 0.7; at 4 weeks: 1.2 ± 0.4; baseline: 3.8 ± 0.4; P< .0001). Twenty stents were removed for clinical indications, with technical success of 100{\%}. All leaks sealed after SEMS placement and did not recur after stent removal. All benign strictures recurred after stent removal. Adverse events included migration (14{\%}), chest pain (11{\%}), and dysphagia from tissue hyperplasia (6{\%}). There was no stent-related mortality. Limitations: Nonrandomized, single-center study. Conclusion: The new esophageal SEMS was effective in relieving malignant dysphagia, allowed for precise placement, and was easily removable. It was effective in treating benign esophageal fistulas and leaks. Stent-related adverse events were acceptable.",
author = "Dua, {Kulwinder S.} and Latif, {Sahibzada U.} and Juliana Yang and Fang, {Tom C.} and Abdul Khan and Young Oh",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.gie.2014.02.005",
language = "English (US)",
volume = "80",
pages = "577--585",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Efficacy and safety of a new fully covered self-expandable non-foreshortening metal esophageal stent

AU - Dua, Kulwinder S.

AU - Latif, Sahibzada U.

AU - Yang, Juliana

AU - Fang, Tom C.

AU - Khan, Abdul

AU - Oh, Young

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background: Fully covered esophageal self-expandable metal stents (SEMSs) are potentially removable but can be associated with high migration rates. For precise positioning, non-foreshortening SEMSs are preferred. Recently, a new fully covered non-foreshortening SEMS with anti-migration features was introduced. Objective: To evaluate the efficacy and safety of this new esophageal SEMS. Design: Retrospective study. Setting: Single, tertiary-care center. Patients: Consecutive patients with malignant and benign strictures with dysphagia grade of R3 and patients with fistulas/leaks were studied. Interventions: Stent placement and removal. Main Outcome Measurements: Technical success in stent deployment/removal, efficacy in relieving dysphagia and sealing fistulas/leaks, and adverse events. Results: Forty-three stents were placed in 35 patients (mean [± standard deviation] age 65 ± 11 years; 31 male), 24 for malignant and 11 for benign (5 strictures, 6 leaks) indications. Technical success in precise SEMS placement was 100%. The after-stent dysphagia grade improved significantly (at 1 week: 1.5 ± 0.7; at 4 weeks: 1.2 ± 0.4; baseline: 3.8 ± 0.4; P< .0001). Twenty stents were removed for clinical indications, with technical success of 100%. All leaks sealed after SEMS placement and did not recur after stent removal. All benign strictures recurred after stent removal. Adverse events included migration (14%), chest pain (11%), and dysphagia from tissue hyperplasia (6%). There was no stent-related mortality. Limitations: Nonrandomized, single-center study. Conclusion: The new esophageal SEMS was effective in relieving malignant dysphagia, allowed for precise placement, and was easily removable. It was effective in treating benign esophageal fistulas and leaks. Stent-related adverse events were acceptable.

AB - Background: Fully covered esophageal self-expandable metal stents (SEMSs) are potentially removable but can be associated with high migration rates. For precise positioning, non-foreshortening SEMSs are preferred. Recently, a new fully covered non-foreshortening SEMS with anti-migration features was introduced. Objective: To evaluate the efficacy and safety of this new esophageal SEMS. Design: Retrospective study. Setting: Single, tertiary-care center. Patients: Consecutive patients with malignant and benign strictures with dysphagia grade of R3 and patients with fistulas/leaks were studied. Interventions: Stent placement and removal. Main Outcome Measurements: Technical success in stent deployment/removal, efficacy in relieving dysphagia and sealing fistulas/leaks, and adverse events. Results: Forty-three stents were placed in 35 patients (mean [± standard deviation] age 65 ± 11 years; 31 male), 24 for malignant and 11 for benign (5 strictures, 6 leaks) indications. Technical success in precise SEMS placement was 100%. The after-stent dysphagia grade improved significantly (at 1 week: 1.5 ± 0.7; at 4 weeks: 1.2 ± 0.4; baseline: 3.8 ± 0.4; P< .0001). Twenty stents were removed for clinical indications, with technical success of 100%. All leaks sealed after SEMS placement and did not recur after stent removal. All benign strictures recurred after stent removal. Adverse events included migration (14%), chest pain (11%), and dysphagia from tissue hyperplasia (6%). There was no stent-related mortality. Limitations: Nonrandomized, single-center study. Conclusion: The new esophageal SEMS was effective in relieving malignant dysphagia, allowed for precise placement, and was easily removable. It was effective in treating benign esophageal fistulas and leaks. Stent-related adverse events were acceptable.

UR - http://www.scopus.com/inward/record.url?scp=84922430004&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922430004&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2014.02.005

DO - 10.1016/j.gie.2014.02.005

M3 - Article

C2 - 24685007

AN - SCOPUS:84922430004

VL - 80

SP - 577

EP - 585

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 4

ER -