Nitinol Esophageal Stents: New Designs and Clinical Indications |
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Authors: | Ernst-Peter Strecker Irene Boos Sylvia Vetter Michael Strohm Sigurd Domschke |
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Institution: | (1) Department of Radiology and Nuclear Medicine, Diakonissen-Krankenhaus, Diakonissenstr. 28, D-76191 Karlsruhe, Germany |
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Abstract: | Purpose To evaluate the clinical use of covered and noncovered, knitted nitinol stents in patients presenting new stent indications.
Methods Self-expandable, knitted nitinol stents were implanted in four patients for treatment of dysphagia. In two patients who had
malignant strictures and had esophago-respiratory fistulae and in one patient with an esophagocutaneous fistula, polytetrafluoroethylene
(PTFE)-covered stents were implanted. One patient received a noncovered stent, but a retrograde approach through a percutaneous
endoscopic gastrostomy (PEG) fistula had to be chosen for recanalization of an esophageal occulusion. Two patients received
stents for treatment of benign strictures.
Results Recanalization of the stricture and stent implantation were performed under fluoroscopic control without any procedure-related
morbidity or mortality. Dysphagia improved in all patients and the esophageal fistulae could be sealed off by covered stents.
During a maximum follow-up of 18 months, there was no stent migration or esophageal perforation. Complications observed were
stent stenosis due to food impaction (1/4) and benign stent stenosis (2/2). Most complications could be treated by the interventional
radiologist.
Conclusion Self-expandable, covered Nitinol stents provide an option for the treatment of dysphagia combined with esophageal fistulae.
In combination with interventional radiology techniques, even complex strictures are accessible. For benign strictures, the
value of stent treatment has not yet been proven. |
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Keywords: | Esophagus Stenosis or obstruction Interventional procedure Grafts and prostheses |
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