NITINOL ESOPHAGEAL STENTS - NEW DESIGNS AND CLINICAL INDICATIONS

Purpose: To evaluate the clinical use of covered and noncovered, knitt ed nitinol stents in patients presenting new stent indications, Method s: Self-expandable, knitted nitinol stents were implanted in four pati ents for treatment of dysphagia. In two patients who had malignant str ictures and had esophago-respiratory fistulae and in one patient with an esophagocutaneous fistula, polytetrafluoroethylene (PTFE)-covered s tents were implanted. One patient received a noncovered stent, but a r etrograde approach through a percutaneous endoscopic gastrostomy (PEG) fistula had to be chosen for recanalization of an esophageal occlusio n. Two patients received stents for treatment of benign strictures. Re sults: Recanalization of the stricture and stent implantation were per formed under fluoroscopic control without any procedure-related morbid ity or mortality. Dysphagia improved in all patients and the esophagea l fistulae could be sealed off by covered stents, During a maximum fol low-up of 18 months, there was no stent migration or esophageal perfor ation. Complications observed were stent stenosis due to food impactio n (1/4) and benign stent stenosis (2/2). Most complications could be t reated by the interventional radiologist. Conclusion: Self-expandable, covered Nitinol stents provide an option for the treatment of dysphag ia combined with esophageal fistulae. In combination with intervention al radiology techniques, even complex strictures are accessible, For b enign strictures, the value of stent treatment has not yet been proven .