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New esophageal stent relieved malignant dysphagia
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A new esophageal self-expandable metal stent with a non-foreshortening feature effectively treated malignant dysphagia and allowed for removability, according to recent study data.
The retrospective analysis included 43 self-expandable metal stents (SEMs) placed in 35 patients (mean age, 65 years; 31 men) for 11 benign (five strictures, six leaks) and 24 malignant indications at a tertiary-care center from October 2011 through April 2013. Mean dysphagia grade at baseline was 3.8 ± 0.4, and main outcome measurement was successful stent deployment and removal, efficacy in relieving dysphagia and sealing fistulas/leaks, and adverse events.
The SEMS being tested (EndoMAXX; Merit Medical Endotek) includes anti-migration struts with more surface area and more angle per height. Fully silicon-coated, it has a metal purse-string loop and is laser cut from a thicker, single, nitinol tube.
Dysphagia grade improved after stent placement (week 1: 1.5 ± 0.7; week 4: 1.2 ± 0.4; P<.0001).
Clinical implications required removal of 20 stents. After SEMS placement, all leaks were sealed and did not recur after SEMS removal. All benign strictures recurred after stent removal. Among adverse events were migration (14%), chest paint (11%) and dysphagia from tissue hyperplasia (6%). No deaths were reported for stent-related issues.
“The non-foreshortening feature of this stent allowed for precise placement and its fully covered feature allowed for removability,” the investigators wrote. “The stent was also effective in treating benign esophageal conditions, especially fistulas and leaks.”
Disclosure: The researchers report no relevant financial disclosures.
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