A new partially covered metal stent for palliation of malignant dysphagia: a prospective follow-up study.
BACKGROUND
Metal stents are frequently used for palliation of malignant dysphagia. Recently, a new stent design, the partially covered Wallflex stent (Boston Scientific, Natick, Mass), has been introduced.


OBJECTIVE
To determine clinical effectiveness and safety of the esophageal Wallflex stent for the palliation of dysphagia.


METHODS
A prospective follow-up study evaluating a new stent design.


METHODS
Three tertiary-care referral centers.


METHODS
This study involved 37 patients with cancer of the esophagus or gastric cardia.


METHODS
Stent placement.


METHODS
Data were collected regarding technical and clinical outcome, complications, recurrent dysphagia, and survival.


RESULTS
A total of 37 patients (median age, 67 years; range, 48-84 years; 22 men [59%]) had a Wallflex stent placed. Stent placement was technically successful in all but 1 patient. Dysphagia improved from a median dysphagia score of 3 (ability to swallow liquids only) to 1 (ability to eat some solid foods) 4 weeks after stent placement. Major complications occurred in 3 patients (8%; pneumonia in 1, severe pain in 2), and 1 patient (3%) died from a complication (pneumonia). Minor complications included mild retrosternal pain in 10 patients (27%) and regurgitation in 7 patients (19%). In total, 8 patients (22%) developed recurrent dysphagia because of stent migration (n = 2 [6%]), food impaction (n = 2 [6%]), or tissue ingrowth or overgrowth (n = 4 [10%]).


CONCLUSIONS
Nonrandomized study design.


CONCLUSIONS
Placement of a partially covered Wallflex stent is safe and effective for the palliation of malignant dysphagia, with migration and tissue in- and overgrowth rates comparable to those of similarly designed stents. Retrosternal pain may occur more often with this stent than with other stent designs.
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Petra G
PG
van Boeckel
Peter D
PD
Siersema
Richard
R
Sturgess
Laura
L
Dwyer
Isaac
I
Raijman
Meike M
MM
Hirdes
Frank P
FP
Vleggaar
D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D020099:Coated Materials, Biocompatible; D003680:Deglutition Disorders / Q000628:therapy*; D019544:Equipment Failure Analysis; D004938:Esophageal Neoplasms / Q000628:therapy*; D004940:Esophageal Stenosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011014:Pneumonia / Q000209:etiology; D011474:Prosthesis Design; D012008:Recurrence; D012826:Silicone Elastomers; D015607:Stents / Q000009:adverse effects
D020099:Coated Materials, Biocompatible; D012826:Silicone Elastomers