Treatment of Malignant Esophageal Obstructions with Covered Metallic Z Stents: Long-term Results in 52 Patients

Richard R. Saxon, Robert E. Barton, Ronald M. Katon, Bryan D. Petersen, Paul C. Lakin, Hans Timmermans, Barry Uchida, Frederick S. Keller, Josef Rösch

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Purpose: To prospectively evaluate the clinical efficacy of silicone-covered Gianturco-Rösch self-expandable Z (GRZ) stents in the treatment of malignant esophageal obstruction. Patients and Methods: GRZ stents were placed in 52 patients (39 men, 13 women) with severe dysphagia due to high-grade malignant esophageal obstruction. Results: Stent placement was technically successful, and immediate relief of dysphagia was achieved in 50 of 52 patients (96%), with long-term relief in 47 patients (90%). Fifty-one patients (98%) died during follow-up (range, 1 week to 33 months; mean, 4.3 months). Late complications were most prevalent and included stent migration (n = 5), food impaction (n = 2), chest pain (n = 2), membrane disruption with tumor ingrowth (n = 1), granulomatous reaction above the stent (n = 1), esophageal perforation with mediastinitis (n = 1), and upper gastrointestinal hemorrhage (n = 4). Twelve complications were easily managed with medical, endoscopic, or radiologic intervention. Four deaths may have been related to stent placement (early mortality rate, 7.7%). Conclusion: GRZ stents provide relatively safe and effective long-term palliation in patients with severe, malignant esophageal obstruction.

Original languageEnglish (US)
Pages (from-to)747-754
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume6
Issue number5
DOIs
StatePublished - Sep 1995

Keywords

  • Esophagus, grafts and prostheses, 71.1269
  • Esophagus, neoplasms, 71.321, 71.331
  • Esophagus, stenosis or obstruction, 71.321

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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