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Palliation of malignant esophageal strictures with self-expanding nitinol stents: Drawbacks and complications
被引:90
作者:
Acunas, B
Rozanes, I
Akpinar, S
Tunaci, A
Tunaci, M
Acunas, C
机构:
[1] Istanbul Medical Faculty, Department of Radiology, Çapa 34390, Istanbul
来源:
关键词:
esophagus;
interventional procedure;
neoplasms;
stenosis or obstruction;
stents and prostheses;
D O I:
10.1148/radiology.199.3.8637981
中图分类号:
R8 [特种医学];
R445 [影像诊断学];
学科分类号:
1002 ;
100207 ;
1009 ;
摘要:
PURPOSE: To evaluate the usefulness of self-expanding nitinol stents in the palliative treatment of malignant dysphagia. MATERIALS AND METHODS: Eighty self-expanding nitinol stents Were placed in 59 patients (43 men, 16 women; mean age, 55 years; age range, 23-75 years) with inoperable malignant stenosis due to squamous cell carcinoma of the esophagus (n = 36), adenocarcinoma (n = 19), invasion of the esophagus due to carcinoma of the lung (n = 2), and recurrent anastomotic carcinoma (n = 2). Dysphagia was graded on a scale of 0 to 3. Follow-up esophagograms were obtained to evaluate stent patency. RESULTS: Stent placement was successful in all patients. The severity of dysphagia decreased at least one grade in all but one patient. Tumor ingrowth and overgrowth were seen in 21 (36%) patients 2 days to 7 months after stent placement and caused recurrent dysphagia. These 21 patients underwent balloon dilation and additional stent placement. A mediastinal fistula was seen in three patients (5%), ulceration in four (7%), stent torsion in three (5%), and incomplete expansion of the stent in two (2%). Repeat intervention was necessary in 51% of the patients. CONCLUSION: There is a substantial range of drawbacks and complications associated with the use of self-expanding nitinol stents for palliation of malignant esophageal strictures. A covering would be necessary to prevent tumor ingrowth.
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页码:648 / 652
页数:5
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