Gs. Jung et al., Malignant gastroduodenal obstructions: Treatment by means of a covered expandable metallic stent - Initial experience, RADIOLOGY, 216(3), 2000, pp. 758-763
Citations number
25
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To investigate the technical feasibility and clinical effectivenes
s of a polyurethane-covered expandable nitinol stent in the treatment of ma
lignant gastroduodenal obstructions.
MATERIALS AND METHODS: The stent was constructed in-house by weaving a sing
le thread of 0.2-mm nitinol wire in a tubular configuration and was covered
with polyurethane solution by means of a dipping method. With fluoroscopic
guidance, the stent was placed in 19 consecutive patients with malignant g
astric outlet obstruction (n = 15) or duodenal obstruction (n = 4). All pat
ients had severe nausea and recurrent vomiting, and their obstructions were
inoperable.
RESULTS: Stent placement was technically successful in all but one patient.
After stent placement, symptoms improved in all but one patient, who had a
nother stenosis at the proximal jejunum. One patient with stent placement i
n the second portion of the duodenum became jaundiced. During the mean foll
ow-up of 11 weeks, stent migration occurred in five patients 1-4 days after
the procedure. All patients with stent migration were treated by means of
placing a second, uncovered nitinol stent. Two of these five patients showe
d recurrence of stricture because of tumor ingrowth; they underwent coaxial
placement of a third, covered nitinol stent with good results.
CONCLUSION: Placement of a polyurethane-covered expandable nitinol stent se
ems to be technically feasible and effective for palliative treatment of in
operable malignant gastroduodenal obstructions. Stent migration, however, i
s problematic and requires further investigation.