title: Comparison of double-layered and covered Niti-S stents for palliation of malignant dysphagia.
abstract: OBJECTIVE
  Covered metal stents have been accepted as the treatment of choice for malignant dysphagia caused by esophageal and gastric cardia cancer, but stent migration is a major shortcoming. A double-layered Niti-S stent was therefore introduced to obviate this problem. We aimed to compare double-layered and covered Niti-S stents regarding safety, efficacy, and feasibility in the treatment of malignant dysphagia.
  
  
  METHODS
  Thirty-seven consecutive patients with malignant dysphagia due to inoperable esophageal or gastric cardia cancer were enrolled in a prospective, randomized study. The main outcomes were technical success, improvement in dysphagia score after stent insertion, and complications.
  
  
  RESULTS
  Technical success was achieved at a similar rate in both groups (covered, 19/19 [100%]vs double layered, 16/17 [94%]). A week after stent insertion, the mean dysphagia score improved significantly in the covered and double-layered groups compared to baseline (from 2.95 +/- 0.52 and 2.88 +/- 0.33 to 1.00 +/- 0.47 and 1.06 +/- 0.24, respectively; P < 0.001). There was no difference in the survival of the patients in the two groups. The overall complications, including stent migration and tumor overgrowth, occurred more frequently with covered stents (11/19 [58%]) than double-layered stents (2/17 [12%]; P = 0.006).
  
  
  CONCLUSIONS
  Newly-developed, self-expanding metal stents, (covered and double-layered Niti-S stents) were equally effective and feasible treatments for malignant dysphagia. However, double-layered Niti-S stents are preferable due to their favorable safety profile.
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Kim
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Park
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Cho
authors.forename: Won Young
authors.initials: WY
authors.lastname: Tak
authors.forename: Young Oh
authors.initials: YO
authors.lastname: Kweon
authors.forename: Sung Kook
authors.initials: SK
authors.lastname: Kim
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Choi
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals