Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas

Mao Qiang Wang, Daniel Y. Sze, Zhong Pu Wang, Zhi Qiang Wang, Yu Ao Gao, Michael D. Dake

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136 Scopus citations

Abstract

PURPOSE: To evaluate delayed complications after esophageal expandable metallic stent placement. MATERIALS AND METHODS: From April 1993 to December 1997, 90 expandable metallic stents were placed in 82 consecutive patients with inoperable malignant esophageal obstruction (n = 49) or malignant esophagorespiratory fistula (n = 33). Stents used included covered Gianturco-Rosch Z stents (n = 20), Wallstents (covered, n = 31; uncovered, n = 13), and Ultraflex stents (covered, n = 8; uncovered, n = 10). Patients were followed prospectively and monitored for delayed complications, defined as major (hemorrhage, tracheal compression, stent migration, perforation or fistula formation, granulomatous obstruction, tumor ingrowth and overgrowth, funnel phenomenon, and stent covering disruption) or minor (reflux, chest pain, and food impaction). RESULTS: Mean survival was 4.5 months after stent placement (range, 3 weeks to 26 months). The overall incidence of delayed complications was 64.6%, with 17 patients (20.7%) experiencing more than one complication. The rates of delayed complications in patients with Z stents, Wallstents, and Ultraflex stents were 75.0%, 68.1%, and 44.4%, respectively (P ,! < .05). Most complications were life-threatening and occurred more frequently when stents were placed in the proximal third of the esophagus, compared with more distally (P < .05). Thirteen patients (15.9%) died from complications directly related to stent placement. CONCLUSION: Esophageal stent placement for malignant obstruction or fistula is associated with a substantial incidence of delayed complications.

Original languageEnglish (US)
Article number61886
Pages (from-to)465-474
Number of pages10
JournalJournal of Vascular and Interventional Radiology
Volume12
Issue number4
DOIs
Publication statusPublished - Jan 1 2001
Externally publishedYes

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Keywords

  • Esophagus, stenosis or obstruction
  • Fistula, esophagorespiratory
  • Stents and prostheses

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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