Covered expandable nitinol stents for malignant gastroduodenal obstructions.
OBJECTIVE
The aim of the present study was to investigate the clinical effectiveness, safety, and outcome associated with the use of covered expandable Nitinol stents (Taewoong Medical, Seoul, Korea) for the treatment of malignant gastroduodenal obstructions.


METHODS
Between March 2001 and October 2004, covered expandable Nitinol stents were placed in 68 consecutive patients under endoscopic and fluoroscopic guidance for the following reasons: gastric carcinoma (n = 49), recurrent carcinoma after partial gastrectomy (n = 7), or another malignant neoplasm involving the duodenum (n = 12).


RESULTS
Technical success was achieved in 60 of the 68 patients (88.2%). After stent placement, mean dysphagia score improved from a mean of 3.5 to 1.2 (P < 0.001). The mean period of primary stent patency was 107.2 days. During follow up (mean 4.4 months; range, 1-15 months), major complications (migration [6], bleeding [3], perforation [1], ingrowth [1], overgrowth [7], fistula [1]) occurred in 19 patients (27.9%), and stent migration occurred in six (8.8%) (proximal migration into the stomach [n = 3], or distal migration [n = 3]). Recurrent dysphagia (mainly due to tumor ingrowth/overgrowth) occurred in eight patients (11.8%).


CONCLUSIONS
Covered expandable Nitinol stents appear to offer an effective and feasible palliative therapy in patients with a malignant gastroduodenal obstruction.
Seo
Eun H
EH
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea.
Jung
Min K
MK
Park
Min J
MJ
Park
Kwan S
KS
Jeon
Seong W
SW
Cho
Chang M
CM
Tak
Won Y
WY
Kweon
Young O
YO
Kim
Sung K
SK
Choi
Yong H
YH
D000368:Aged; D000497:Alloys; D004380:Duodenal Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D004384:Duodenoscopy / Q000009:adverse effects; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000628:therapy; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol