Radiological evaluation of covered self-expandable metallic stents used for palliation in patients with malignant esophageal strictures.
OBJECTIVE
To study the role of self-expandable metallic stents in malignant esophageal strictures in terms of patency, improved dysphagia score, and possible associated complications.


METHODS
Twenty-two patients with inoperable carcinoma of the esophagus underwent stent placement. Four different varieties of covered stents were used. Stenting was performed under fluoroscopic guidance and local pharyngeal anesthesia. During follow-up, patients were examined clinically and radiologically to assess the effectiveness of stents in relieving dysphagia, to check the stent position, patency, and possible complications.


RESULTS
Fluoroscopic placement of the stent was successful and well tolerated in all patients without any serious complications. Accurate stent placement was possible in 95% of cases. The mean dysphagia score prior to stenting was 3.5 and poststent 1.2, with an improvement of 2.3 degrees. In two patients with associated fistulas, complete closure was seen after stent insertion. There was poor stent expansion in three patients. Significant tumor overgrowth occurred in two patients, and a second overlapping stent was deployed in one case. Three patients developed food impaction, which needed endoscopic removal of impacted food in two cases.


CONCLUSIONS
Fluoroscopic placement of self-expandable metallic stents is a safe and effective method of palliating severe dysphagia and fistulas in patients with inoperable esophageal carcinoma. However, complications such as tumor overgrowth and food impaction may require reintervention after stent placement.
Neyaz
Z
Z
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Srivastava
Deep N
DN
Thulkar
S
S
Bandhu
S
S
Gamanagatti
S
S
Julka
P K
PK
Chattopadhyaya
T K
TK
D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D018709:Statistics, Nonparametric; D015607:Stents; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D008670:Metals; D001466:Barium Sulfate