MALIGNANT ESOPHAGEAL STRICTURES - TREATMENT WITH A SELF-EXPANDING NITINOL STENT

A self-expanding esophageal nitinol stent was implanted under fluorosc opic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamo us cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastom otic carcinoma (n = 8), and mediastinal tumors (n = 6). Eight stents w ere balloon dilated to maximum diameter immediately after insertion. S ixteen stents self-expanded to maximum diameter within 24 hours, and t he other stents expanded to maximum diameter during further observatio n. There were no serious stent-related complications, and the dysphagi a was reduced considerably in all patients immediately after stent ins ertion. Persistent tumor bleeding occurred in two patients, and ingrow th of tumor into the stent was seen in eight patients. Two stents occl uded due to tumor ingrowth but were successfully recanalized with endo scopic laser coagulation. At the end of the study, 28 patients were de ad with a mean survival of 2.9 months (range, 0.1-7.0 months), and 12 patients were alive with a mean follow-up of 8.8 months (range, 4.0-15 .0 months).