Endoscopy 2014; 46(12): 1101-1105
DOI: 10.1055/s-0034-1377632
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A new fully covered metal stent with anti-migration features for the treatment of malignant dysphagia

Daisy Walter
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Maarten W. van den Berg
2   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Jeanin E. van Hooft
2   Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
,
Henk Boot
3   Department of Gastroenterology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
,
Robert C. H. Scheffer
4   Department of Gastroenterology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
,
Frank P. Vleggaar
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Peter D. Siersema
1   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
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Publikationsverlauf

submitted29. Januar 2014

accepted after revision20. Juni 2014

Publikationsdatum:
30. September 2014 (online)

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Background and study aims: A new esophageal stent with two anti-migration features was developed to minimize migration. The aim of this study was to evaluate the clinical efficacy and safety of this stent in patients with malignant dysphagia.

Patients and methods: A total of 40 patients with dysphagia due to a malignant obstruction of the esophagus were prospectively enrolled in this cohort study.

Results: Stent placement was technically successful in 39 patients (98 %). The median dysphagia-free time after stent placement was 220 days (95 % confidence interval 94 – 345 days). Nine patients (23 %) experienced recurrent dysphagia due to tissue overgrowth (n = 2), stent fracture (n = 1), and partial (n = 5) or complete (n = 1) stent migration. A total of 16 serious adverse events occurred in 14 patients (36 %), with hemorrhage (n = 3) and severe nausea or vomiting (n = 3) being the most common causes.

Conclusions: This new stent design was effective for the palliation of malignant dysphagia and had a low rate of recurrent dysphagia. However, despite the anti-migration features, stent migration was still a major cause of recurrent dysphagia. Furthermore, treatment was associated with a high adverse event rate.

Dutch Trial Registration (NTR 3313)