Stent collapse as a delayed complication of placement of a covered gastroduodenal stent.
OBJECTIVE
The purpose of this study was retrospective evaluation of the incidence, predictive factors, and interventional management of stent collapse after placement of a covered metallic stent in patients with obstruction of the gastric outlet or duodenum due to malignant disease.


METHODS
Among 259 patients with symptomatic malignant gastroduodenal obstruction successfully treated with stent placement, stent collapse occurred in 12 (4.6%) of the patients 34-270 days (mean, 101.8 days) after stent placement. Multivariate analysis was performed to evaluate factors predictive of stent collapse. Interventional management of stent collapse also was evaluated.


RESULTS
Multivariate analysis showed that presence of the stent in the peripyloric region (odds ratio, 27.745; p = 0.036), longer survival time (odds ratio, 1.016; p < 0.001), and absence of chemotherapy after stent placement (odds ratio, 31.661; p = 0.048) were independent predictors of stent collapse. Eleven patients with stent collapse were successfully treated with placement of a second bare stent. The twelfth patient refused further treatment.


CONCLUSIONS
Stent collapse is an uncommon delayed complication of placement of covered metallic stents in patients with malignant gastroduodenal obstruction. Collapse occurs most commonly in the peripyloric region, in patients with longer survival times, and in patients who do not undergo chemotherapy after stent placement. Stent collapse can be managed by coaxial placement of a second bare stent into the collapsed stent.
Kim
Jin Hyoung
JH
Department of Radiology, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul, Seoul, South Korea 138-736.
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Choi
Eugene
E
Kim
Tae Won
TW
Lee
Sung Koo
SK
Kim
Byung Sik
BS
D000328:Adult; D000368:Aged; D015897:Comorbidity; D004379:Duodenal Neoplasms / Q000453:epidemiology / Q000628:therapy; D004380:Duodenal Obstruction / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D015641:Radiography, Interventional / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome