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Covered Retrievable Expandable Nitinol Stents in Patients with Benign Esophageal Strictures: Initial Experience¹

¹ From the Departments of Diagnostic Radiology (H.Y.S., D.H.L.), Internal Medicine (H.Y.J., S.B.K., Y.I.M.), Thoracic and Cardiovascular Surgery (S.I.P.), and Biomedical Engineering (S.G.K.), Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-Dong, Songpa-Ku, Seoul 138-736, Korea. Received November 8, 1999; revision requested December 10; revision received February 15, 2000; accepted February 23. Supported by a grant (HMP-98-G-2-043) of the Highly Advanced National Project, Ministry of Health and Welfare, Republic of Korea. Address correspondence to H.Y.S. (e-mail: hysong@www.amc.seoul.kr).

PURPOSE: To investigate the safety and clinical effectiveness of covered retrievable expandable nitinol stents in 25 patients with a benign esophageal stricture.

MATERIALS AND METHODS: Under fluoroscopic guidance, covered retrievable expandable nitinol stents were placed in 25 patients with a benign esophageal stricture and were removed with a retrieval hook 1–8 weeks later.

RESULTS: Stent placement was successful in all patients, with no procedural complications. After stent placement, all patients could ingest solid food. The stents were successfully removed from all but two patients. One patient passed the stent via the rectum, and the other regurgitated a high cervical stent. After stent removal, one patient developed a small esophagobronchial fistula, which spontaneously sealed within 1 week of stent removal. After stent removal or migration, all patients could ingest solid food. During follow-up (mean, 13 months; range, 2–25 months) after stent removal or migration, 12 patients maintained their improvement in dysphagia and needed no further treatment. Thirteen patients with recurrence were treated by means of repeat balloon dilation.

CONCLUSION: Use of retrievable expandable nitinol stents seems to be a safe and effective method of treatment in selected patients with benign esophageal strictures.

Index terms: Esophagus, grafts and prostheses, 71.1269, 71.744 • Esophagus, interventional procedure, 71.1269 • Esophagus, stenosis or obstruction, 71.744

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