Comparison of complications of self-expanding metal and conventional esophageal prostheses: 7 year experience

R. M. Bashir, D. E. Fleischer, S. W. Fry, A. M. Axclrad, F. H. Al-Kawas, S. B. Benjamin

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Expandable metal esophageal prosthescs (EMP) are considered easier to deploy than conventional plastic prostheses (CPP). however, data companng complications are limited. We reviewed our 7 year experience comparing plastic and metal stents for palliation of inoperable malignant esophageal stenoses. Methods: All patients who underwent successful esophageal stent placement between 11/87 and 11/95 were reviewed Data collection included patient demographics, stent type, stent-related complications (cpx), and ability to occlude a tracheoesophageal (TE) fistula. All complications had been prospectively recorded and evaluated at monthly QA meetings Results 96 patients (68 M. 28F, mean= 67.2y) underwent 118 esophageal stent placements (95 CPP (Wilson-Cook 74,Bard 14,Key-Med 7); 23 EMP (Z. H.Wallstent 6,Ultrailex 2,Esophacoil 1)) for malignant obstruction (99 Esoph CA, 4 Lung CA) Initial stent deployment was unsuccessful in 6 patients (6%) Stent-related chest pain occurred in 8/23 (35%) EMP and 2 (2%) CPP. Other complications requiring medical therapy, including arrhythmias, aspiration, pneumothorax, bleeding, and skin laceration were similar for CPP and EMP See table for complication data. EMP (n=23) CPP (n=95) p-value ALL Complications (Cpx) 18 (78%) 46 (48%) p< 05 1) Requiring medical therapy 11 (48%) 7 (7%) p< 01 2) Stent migration (<24 h) 4 (17%) 4 (4%) NS (>24h) 4 (17%) 20 (21%) NS -requiring add'l stent/EGD 7 (30%) 14 (15%) NS 3) Tumor ingrowth 10 (43%) 6 (6%) p< .001 4) Perforation 1 (4%) 5 (5%) NS 5) Stent-related death 1 (4%) 2 (2%) NS TE fistula occlusion 3/3 (100%) 11/14 (79%) NS Conclusions: 1) Overall, complications occured more frequently in patients with EMP than CPP (p<.05). 2) Tumor ingrowth was more common in patients with EMP than CPP (p<.01). 3) Stent-related chest pain was more common in patients EMP than CPP (p<.001). 4) The incidence of stent migration, additional stent placement, perforation, and stent-related deaths were similar for EMP and CPP. 4) CPP and coated EMP are similarly effective in the management of TE fistula.

Original languageEnglish (US)
Pages (from-to)291
Number of pages1
JournalGastrointestinal Endoscopy
Volume43
Issue number4
StatePublished - 1996
Externally publishedYes

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Prostheses and Implants
Stents
Plastics
Metals
Tracheoesophageal Fistula
montirelin
Chest Pain
Esophageal Stenosis
Lacerations
Pneumothorax
Cardiac Arrhythmias
Neoplasms
Demography
Hemorrhage
Lung
Skin

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Bashir, R. M., Fleischer, D. E., Fry, S. W., Axclrad, A. M., Al-Kawas, F. H., & Benjamin, S. B. (1996). Comparison of complications of self-expanding metal and conventional esophageal prostheses: 7 year experience. Gastrointestinal Endoscopy, 43(4), 291.

Comparison of complications of self-expanding metal and conventional esophageal prostheses : 7 year experience. / Bashir, R. M.; Fleischer, D. E.; Fry, S. W.; Axclrad, A. M.; Al-Kawas, F. H.; Benjamin, S. B.

In: Gastrointestinal Endoscopy, Vol. 43, No. 4, 1996, p. 291.

Research output: Contribution to journalArticle

Bashir, RM, Fleischer, DE, Fry, SW, Axclrad, AM, Al-Kawas, FH & Benjamin, SB 1996, 'Comparison of complications of self-expanding metal and conventional esophageal prostheses: 7 year experience', Gastrointestinal Endoscopy, vol. 43, no. 4, pp. 291.
Bashir RM, Fleischer DE, Fry SW, Axclrad AM, Al-Kawas FH, Benjamin SB. Comparison of complications of self-expanding metal and conventional esophageal prostheses: 7 year experience. Gastrointestinal Endoscopy. 1996;43(4):291.
Bashir, R. M. ; Fleischer, D. E. ; Fry, S. W. ; Axclrad, A. M. ; Al-Kawas, F. H. ; Benjamin, S. B. / Comparison of complications of self-expanding metal and conventional esophageal prostheses : 7 year experience. In: Gastrointestinal Endoscopy. 1996 ; Vol. 43, No. 4. pp. 291.
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abstract = "Background: Expandable metal esophageal prosthescs (EMP) are considered easier to deploy than conventional plastic prostheses (CPP). however, data companng complications are limited. We reviewed our 7 year experience comparing plastic and metal stents for palliation of inoperable malignant esophageal stenoses. Methods: All patients who underwent successful esophageal stent placement between 11/87 and 11/95 were reviewed Data collection included patient demographics, stent type, stent-related complications (cpx), and ability to occlude a tracheoesophageal (TE) fistula. All complications had been prospectively recorded and evaluated at monthly QA meetings Results 96 patients (68 M. 28F, mean= 67.2y) underwent 118 esophageal stent placements (95 CPP (Wilson-Cook 74,Bard 14,Key-Med 7); 23 EMP (Z. H.Wallstent 6,Ultrailex 2,Esophacoil 1)) for malignant obstruction (99 Esoph CA, 4 Lung CA) Initial stent deployment was unsuccessful in 6 patients (6{\%}) Stent-related chest pain occurred in 8/23 (35{\%}) EMP and 2 (2{\%}) CPP. Other complications requiring medical therapy, including arrhythmias, aspiration, pneumothorax, bleeding, and skin laceration were similar for CPP and EMP See table for complication data. EMP (n=23) CPP (n=95) p-value ALL Complications (Cpx) 18 (78{\%}) 46 (48{\%}) p< 05 1) Requiring medical therapy 11 (48{\%}) 7 (7{\%}) p< 01 2) Stent migration (<24 h) 4 (17{\%}) 4 (4{\%}) NS (>24h) 4 (17{\%}) 20 (21{\%}) NS -requiring add'l stent/EGD 7 (30{\%}) 14 (15{\%}) NS 3) Tumor ingrowth 10 (43{\%}) 6 (6{\%}) p< .001 4) Perforation 1 (4{\%}) 5 (5{\%}) NS 5) Stent-related death 1 (4{\%}) 2 (2{\%}) NS TE fistula occlusion 3/3 (100{\%}) 11/14 (79{\%}) NS Conclusions: 1) Overall, complications occured more frequently in patients with EMP than CPP (p<.05). 2) Tumor ingrowth was more common in patients with EMP than CPP (p<.01). 3) Stent-related chest pain was more common in patients EMP than CPP (p<.001). 4) The incidence of stent migration, additional stent placement, perforation, and stent-related deaths were similar for EMP and CPP. 4) CPP and coated EMP are similarly effective in the management of TE fistula.",
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T1 - Comparison of complications of self-expanding metal and conventional esophageal prostheses

T2 - 7 year experience

AU - Bashir, R. M.

AU - Fleischer, D. E.

AU - Fry, S. W.

AU - Axclrad, A. M.

AU - Al-Kawas, F. H.

AU - Benjamin, S. B.

PY - 1996

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N2 - Background: Expandable metal esophageal prosthescs (EMP) are considered easier to deploy than conventional plastic prostheses (CPP). however, data companng complications are limited. We reviewed our 7 year experience comparing plastic and metal stents for palliation of inoperable malignant esophageal stenoses. Methods: All patients who underwent successful esophageal stent placement between 11/87 and 11/95 were reviewed Data collection included patient demographics, stent type, stent-related complications (cpx), and ability to occlude a tracheoesophageal (TE) fistula. All complications had been prospectively recorded and evaluated at monthly QA meetings Results 96 patients (68 M. 28F, mean= 67.2y) underwent 118 esophageal stent placements (95 CPP (Wilson-Cook 74,Bard 14,Key-Med 7); 23 EMP (Z. H.Wallstent 6,Ultrailex 2,Esophacoil 1)) for malignant obstruction (99 Esoph CA, 4 Lung CA) Initial stent deployment was unsuccessful in 6 patients (6%) Stent-related chest pain occurred in 8/23 (35%) EMP and 2 (2%) CPP. Other complications requiring medical therapy, including arrhythmias, aspiration, pneumothorax, bleeding, and skin laceration were similar for CPP and EMP See table for complication data. EMP (n=23) CPP (n=95) p-value ALL Complications (Cpx) 18 (78%) 46 (48%) p< 05 1) Requiring medical therapy 11 (48%) 7 (7%) p< 01 2) Stent migration (<24 h) 4 (17%) 4 (4%) NS (>24h) 4 (17%) 20 (21%) NS -requiring add'l stent/EGD 7 (30%) 14 (15%) NS 3) Tumor ingrowth 10 (43%) 6 (6%) p< .001 4) Perforation 1 (4%) 5 (5%) NS 5) Stent-related death 1 (4%) 2 (2%) NS TE fistula occlusion 3/3 (100%) 11/14 (79%) NS Conclusions: 1) Overall, complications occured more frequently in patients with EMP than CPP (p<.05). 2) Tumor ingrowth was more common in patients with EMP than CPP (p<.01). 3) Stent-related chest pain was more common in patients EMP than CPP (p<.001). 4) The incidence of stent migration, additional stent placement, perforation, and stent-related deaths were similar for EMP and CPP. 4) CPP and coated EMP are similarly effective in the management of TE fistula.

AB - Background: Expandable metal esophageal prosthescs (EMP) are considered easier to deploy than conventional plastic prostheses (CPP). however, data companng complications are limited. We reviewed our 7 year experience comparing plastic and metal stents for palliation of inoperable malignant esophageal stenoses. Methods: All patients who underwent successful esophageal stent placement between 11/87 and 11/95 were reviewed Data collection included patient demographics, stent type, stent-related complications (cpx), and ability to occlude a tracheoesophageal (TE) fistula. All complications had been prospectively recorded and evaluated at monthly QA meetings Results 96 patients (68 M. 28F, mean= 67.2y) underwent 118 esophageal stent placements (95 CPP (Wilson-Cook 74,Bard 14,Key-Med 7); 23 EMP (Z. H.Wallstent 6,Ultrailex 2,Esophacoil 1)) for malignant obstruction (99 Esoph CA, 4 Lung CA) Initial stent deployment was unsuccessful in 6 patients (6%) Stent-related chest pain occurred in 8/23 (35%) EMP and 2 (2%) CPP. Other complications requiring medical therapy, including arrhythmias, aspiration, pneumothorax, bleeding, and skin laceration were similar for CPP and EMP See table for complication data. EMP (n=23) CPP (n=95) p-value ALL Complications (Cpx) 18 (78%) 46 (48%) p< 05 1) Requiring medical therapy 11 (48%) 7 (7%) p< 01 2) Stent migration (<24 h) 4 (17%) 4 (4%) NS (>24h) 4 (17%) 20 (21%) NS -requiring add'l stent/EGD 7 (30%) 14 (15%) NS 3) Tumor ingrowth 10 (43%) 6 (6%) p< .001 4) Perforation 1 (4%) 5 (5%) NS 5) Stent-related death 1 (4%) 2 (2%) NS TE fistula occlusion 3/3 (100%) 11/14 (79%) NS Conclusions: 1) Overall, complications occured more frequently in patients with EMP than CPP (p<.05). 2) Tumor ingrowth was more common in patients with EMP than CPP (p<.01). 3) Stent-related chest pain was more common in patients EMP than CPP (p<.001). 4) The incidence of stent migration, additional stent placement, perforation, and stent-related deaths were similar for EMP and CPP. 4) CPP and coated EMP are similarly effective in the management of TE fistula.

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