Selective application of fully covered biliary stents and narrow-diameter esophageal stents for proximal esophageal indications

Maoyin Pang, Michael J. Bartel, Donnesha B. Clayton, Bhaumik Brahmbhatt, Timothy A. Woodward

Research output: Contribution to journalArticle

Abstract

Background Proximal esophageal stents are poorly tolerated and have a high risk of complications. We report our experience using fully covered, biliary, self-expandable metal stents (B-SEMS) and narrow-diameter, esophageal, self-expandable metal stents (NDE-SEMS) for this group of patients. Methods 24 patients underwent placement of B-SEMS or NDE-SEMS for proximal esophageal lesions between 1 January 2011 and 31 July 2016. The outcomes included improvement of dysphagia, healing of fistulas, and adverse events. Results 10 patients received B-SEMS and 14 had NDE-SEMS. Median follow-up time was 11.5 months (range 0.5 – 62 months). In both cohorts, stents were left in place for a mean of 6 weeks. The dysphagia score decreased in 7 (70 %) and 10 (71.4 %) patients, and fistulas resolved in 3/5 (60.0 %) and 5/8 (62.5 %) patients with B-SEMS and NDE-SEMS, respectively. Stent migration occurred in three patients (30.0 %) with B-SEMS and five patients (35.7 %) with NDE-SEMS. Conclusions Both stents were well tolerated and resulted in overall improvement of dysphagia in 70.8 % of patients. B-SEMS appeared to be more favorable for cervical esophageal lesions with narrower diameters, while NDE-SEMS may be better for more distal lesions.

Original languageEnglish (US)
JournalEndoscopy
DOIs
StateAccepted/In press - Jul 13 2018

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Stents
Deglutition Disorders
Fistula
Self Expandable Metallic Stents

ASJC Scopus subject areas

  • Gastroenterology

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Selective application of fully covered biliary stents and narrow-diameter esophageal stents for proximal esophageal indications. / Pang, Maoyin; Bartel, Michael J.; Clayton, Donnesha B.; Brahmbhatt, Bhaumik; Woodward, Timothy A.

In: Endoscopy, 13.07.2018.

Research output: Contribution to journalArticle

Pang, Maoyin ; Bartel, Michael J. ; Clayton, Donnesha B. ; Brahmbhatt, Bhaumik ; Woodward, Timothy A. / Selective application of fully covered biliary stents and narrow-diameter esophageal stents for proximal esophageal indications. In: Endoscopy. 2018.
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abstract = "Background Proximal esophageal stents are poorly tolerated and have a high risk of complications. We report our experience using fully covered, biliary, self-expandable metal stents (B-SEMS) and narrow-diameter, esophageal, self-expandable metal stents (NDE-SEMS) for this group of patients. Methods 24 patients underwent placement of B-SEMS or NDE-SEMS for proximal esophageal lesions between 1 January 2011 and 31 July 2016. The outcomes included improvement of dysphagia, healing of fistulas, and adverse events. Results 10 patients received B-SEMS and 14 had NDE-SEMS. Median follow-up time was 11.5 months (range 0.5 – 62 months). In both cohorts, stents were left in place for a mean of 6 weeks. The dysphagia score decreased in 7 (70 {\%}) and 10 (71.4 {\%}) patients, and fistulas resolved in 3/5 (60.0 {\%}) and 5/8 (62.5 {\%}) patients with B-SEMS and NDE-SEMS, respectively. Stent migration occurred in three patients (30.0 {\%}) with B-SEMS and five patients (35.7 {\%}) with NDE-SEMS. Conclusions Both stents were well tolerated and resulted in overall improvement of dysphagia in 70.8 {\%} of patients. B-SEMS appeared to be more favorable for cervical esophageal lesions with narrower diameters, while NDE-SEMS may be better for more distal lesions.",
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AU - Woodward, Timothy A.

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N2 - Background Proximal esophageal stents are poorly tolerated and have a high risk of complications. We report our experience using fully covered, biliary, self-expandable metal stents (B-SEMS) and narrow-diameter, esophageal, self-expandable metal stents (NDE-SEMS) for this group of patients. Methods 24 patients underwent placement of B-SEMS or NDE-SEMS for proximal esophageal lesions between 1 January 2011 and 31 July 2016. The outcomes included improvement of dysphagia, healing of fistulas, and adverse events. Results 10 patients received B-SEMS and 14 had NDE-SEMS. Median follow-up time was 11.5 months (range 0.5 – 62 months). In both cohorts, stents were left in place for a mean of 6 weeks. The dysphagia score decreased in 7 (70 %) and 10 (71.4 %) patients, and fistulas resolved in 3/5 (60.0 %) and 5/8 (62.5 %) patients with B-SEMS and NDE-SEMS, respectively. Stent migration occurred in three patients (30.0 %) with B-SEMS and five patients (35.7 %) with NDE-SEMS. Conclusions Both stents were well tolerated and resulted in overall improvement of dysphagia in 70.8 % of patients. B-SEMS appeared to be more favorable for cervical esophageal lesions with narrower diameters, while NDE-SEMS may be better for more distal lesions.

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