Comparison of complications of self-expanding metal and conventional esophageal prostheses: 7 year experience

R. M. Bashir, D. E. Fleischer, S. W. Fry, A. M. Axclrad, F. H. Al-Kawas, S. B. Benjamin

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Background: Expandable metal esophageal prosthescs (EMP) are considered easier to deploy than conventional plastic prostheses (CPP). however, data companng complications are limited. We reviewed our 7 year experience comparing plastic and metal stents for palliation of inoperable malignant esophageal stenoses. Methods: All patients who underwent successful esophageal stent placement between 11/87 and 11/95 were reviewed Data collection included patient demographics, stent type, stent-related complications (cpx), and ability to occlude a tracheoesophageal (TE) fistula. All complications had been prospectively recorded and evaluated at monthly QA meetings Results 96 patients (68 M. 28F, mean= 67.2y) underwent 118 esophageal stent placements (95 CPP (Wilson-Cook 74,Bard 14,Key-Med 7); 23 EMP (Z. H.Wallstent 6,Ultrailex 2,Esophacoil 1)) for malignant obstruction (99 Esoph CA, 4 Lung CA) Initial stent deployment was unsuccessful in 6 patients (6%) Stent-related chest pain occurred in 8/23 (35%) EMP and 2 (2%) CPP. Other complications requiring medical therapy, including arrhythmias, aspiration, pneumothorax, bleeding, and skin laceration were similar for CPP and EMP See table for complication data. EMP (n=23) CPP (n=95) p-value ALL Complications (Cpx) 18 (78%) 46 (48%) p< 05 1) Requiring medical therapy 11 (48%) 7 (7%) p< 01 2) Stent migration (<24 h) 4 (17%) 4 (4%) NS (>24h) 4 (17%) 20 (21%) NS -requiring add'l stent/EGD 7 (30%) 14 (15%) NS 3) Tumor ingrowth 10 (43%) 6 (6%) p< .001 4) Perforation 1 (4%) 5 (5%) NS 5) Stent-related death 1 (4%) 2 (2%) NS TE fistula occlusion 3/3 (100%) 11/14 (79%) NS Conclusions: 1) Overall, complications occured more frequently in patients with EMP than CPP (p<.05). 2) Tumor ingrowth was more common in patients with EMP than CPP (p<.01). 3) Stent-related chest pain was more common in patients EMP than CPP (p<.001). 4) The incidence of stent migration, additional stent placement, perforation, and stent-related deaths were similar for EMP and CPP. 4) CPP and coated EMP are similarly effective in the management of TE fistula.

Original languageEnglish (US)
Pages (from-to)291
Number of pages1
JournalGastrointestinal endoscopy
Issue number4
StatePublished - 1996

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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