Nitinol esophageal stents: new designs and clinical indications.
OBJECTIVE
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 occlusion. 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.


CONCLUSIONS
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.
Strecker
E P
EP
Department of Radiology and Nuclear Medicine, Diakonissen-Krankenhaus, Karlsruhe, Germany.
Boos
I
I
Vetter
S
S
Strohm
M
M
Domschke
S
S
D000328:Adult; D000368:Aged; D000497:Alloys; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000628:therapy; D004868:Equipment Failure; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011859:Radiography; D015607:Stents; D013499:Surface Properties
D000497:Alloys; C013616:nitinol; D011138:Polytetrafluoroethylene