Indications and complications of esophageal self expandable metal stents (SEMS): Results of a national survey

The self-reported complication rates for the available SEMS, are unknown. Objective: To determine the self-reported indications and complications derived from the use of SEMS by community gastroenterologists. Material and Methods: A mail in survey to ASGE members. Results: A total of 3,414 surveys were mailed. Only 212 (6.2%) responded. 60% of these physicians had experience with SEMS. 72% percent practiced in a the private setting and 75% had placed ≤ 3 SEMS at the time of this survey. A total of 434 SEMS were placed. The indications for SEMS placement are listed Esop CA EGJ CA Extrinsic TE Fist Failed Leak Coated 62 19 21 40 8 6 Uncoated 93 22 20 NA NA NA Immediate technical complications were as follows: Misplacement Failed Expansion Failed deployment Microvasive (M) 3 10 3 Schneider (S) 4 4 1 Other/NS(O/NS) 14 17 9 Total 21/434 (4.8%) 31/434 (7,1%) 13/434 (3%) Immediate patient complications: Chest Pain Bleed Perforation Migration Death M 1 S 13 2 2 1 O/NS 10 1 3 5 1 Total 24 (5.5%) 1 (0.2%) 5 (1.1%) 7 (1.6%) 2 (0.5%) Delayed patient complications. Bleed Perf Migrt Death Tumor GERD TEfis Dysph M 1 4 3 6 9 9 S 1 2 8 2 2 2 7 O/NS 1 1 8 21 19 10 2 22 Tot(%) 2(0.5) 2(0.5) 14(3) 32(7) 27(6) 21(5) 4(1) 38(9) Conclusions: The rate of technical complications varies from 3-7%. Immediate and delayed patient complications are self reported to vary from 0.2%-5.5% and from 0.5 to 9%. respectively.