Palliative treatment of inoperable malignant esophageal strictures with metal stents: one center's experience with four different stents.
OBJECTIVE
Our center's experience with Ultraflex, Flamingo, SR stent and Flexstent for the palliation of malignant esophageal strictures is reported, and current pertinent literature is reviewed.


METHODS
Stents have been placed under fluoroscopic guidance between August 1993 and February 2002 for the palliation of malignant dysphagia in 116 patients. 59 patients received Ultraflex, 33 patients received Flamingo Wallstent, 20 patients received the SR stent and four patients received Flexstent.


RESULTS
Stent placement was successful in all the patients, with good symptomatic control in 123 out of 126 patients (98%) and no procedure-related complications. Four esophagorespiratory fistulas were successfully closed with covered Flamingo stents. Repeat intervention was necessary in 30 patients (51%) who received the Ultraflex stent, secondary to tumor ingrowth, overgrowth, ulceration, fistula and incomplete expansion. Two patients (6%) who received Flamingo Wallstent died due to gastrointestinal bleeding and one patient had proximal migration. Four patients (20%) who received the SR stent had complete migration of the stent.


CONCLUSIONS
Covered stents were found to provide better long-term palliation compared to uncovered stents. The covered Flamingo Wallstent seems to be the best choice of stent for lesions where crossing the esophagogastric junction is not necessary. For lesions where it is mandatory to cross the junction it may be preferable to use a stent with an antireflux mechanism.
Istanbul Medical Faculty, Department of Radiology, 34390, Istanbul, Capa, Turkey.
Izzet
I
Rozanes
Arzu
A
Poyanli
Bülent
B
Acunaş
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome
D008670:Metals