BENIGN AND MALIGNANT ESOPHAGEAL STRICTURES - TREATMENT WITH A POLYURETHANE-COVERED RETRIEVABLE EXPANDABLE METALLIC STENT

PURPOSE: To evaluate the clinical effectiveness of a polyurethane-cove red, retrievable, self-expandable metallic stent and hook catheter in the treatment of esophageal strictures. MATERIALS AND METHODS: Stents were constructed of 0.4-mm stainless steel wire in a cylindric zigzag configuration of six to nine bends. Four to eight stents were connecte d in tandem by dipping in a polyurethane solution. A nylon loop was ho oked inside to each bend of the proximal portion of the stent and stru ng with a thread. Under fluoroscopic guidance, 22 stents were placed i n 16 patients with a malignant stricture and five patients with a beni gn stricture. The stent was removed with a hook catheter 2 months afte r placement in patients with a benign stricture and when complications occurred in patients with a malignant stricture. All patients had dys phagia with ingestion of soft foods or liquids. RESULTS: Stent placeme nt was technically successful and well tolerated in 20 patients. In on e patient the stent was misplaced but relocated successfully. After st ent placement, all patients were able to ingest solid and/or soft food s without dysphagia. After stent removal, strictures showed improvemen t but recurred in two patients. CONCLUSION: Use of polyurethane-covere d, retrievable expandable stents seems to be a feasible and effective method of treatment of benign and malignant esophageal strictures.