Malignant gastric outlet obstructions: Treatment by means of coaxial placement of uncovered and covered expandable nitinol stents

Gyoo Sik Jung, Ho Young Song, Tae-Seok Seo, Seon Ja Park, Ja Young Koo, Jin Do Huh, Duk Cho Young

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

PURPOSE: To assess whether coaxial placement of uncovered and covered expandable nitinol stents overcomes the disadvantages of the increased migration rate seen with covered stents and the tumor ingrowth seen in uncovered stents in the treatment of malignant gastric outlet obstructions. Materials AND METHODS: Two types of expandable nitinol stent were designed: an uncovered stent and a covered stent. Under fluoroscopic guidance, the uncovered and covered stents were placed coaxially with complete overlap in 39 consecutive patients with malignant gastric outlet obstruction caused by stomach cancer. Food intake capacity was graded on a scale of 0-4. Stent patency rate was estimated by the Kaplan-Meier method. RESULTS: Technical success rate was 97% (38 of 39 patients). After stent placement, food intake capacity improved at least one grade in 36 patients. Stent migration occurred in three patients (8%), that is, partial (n = 2) or complete (n = 1) upward migration of the inner covered stent into the stomach. Two of these patients were treated by placement of an additional covered stent. During the mean follow-up period of 134 days (range, 15-569 d), 10 patients developed recurrent symptoms of obstruction with tumor overgrowth being the most common cause. Nine underwent placement of an additional covered stent with good results. The median period of primary stent patency was 157 days (mean, 278 d). The 30-, 60-, and 180-day patency rates were 97%, 91%, and 39%, respectively. Four patients (10%) died within 1 month after the procedure. CONCLUSION: Coaxial stent placement technique seems to contribute to decreasing the migration rate of the stent and decrease the rate of recurrent obstruction by preventing or delaying tumor ingrowth.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number3
DOIs
Publication statusPublished - 2002 Jan 1
Externally publishedYes

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Gastric Outlet Obstruction
Stents
Therapeutics
nitinol
Eating
Neoplasms

Keywords

  • Stents and prostheses
  • Stomach, stenosis or obstruction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Malignant gastric outlet obstructions : Treatment by means of coaxial placement of uncovered and covered expandable nitinol stents. / Jung, Gyoo Sik; Song, Ho Young; Seo, Tae-Seok; Park, Seon Ja; Koo, Ja Young; Huh, Jin Do; Young, Duk Cho.

In: Journal of Vascular and Interventional Radiology, Vol. 13, No. 3, 01.01.2002, p. 275-283.

Research output: Contribution to journalArticle

Jung, Gyoo Sik ; Song, Ho Young ; Seo, Tae-Seok ; Park, Seon Ja ; Koo, Ja Young ; Huh, Jin Do ; Young, Duk Cho. / Malignant gastric outlet obstructions : Treatment by means of coaxial placement of uncovered and covered expandable nitinol stents. In: Journal of Vascular and Interventional Radiology. 2002 ; Vol. 13, No. 3. pp. 275-283.
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T2 - Treatment by means of coaxial placement of uncovered and covered expandable nitinol stents

AU - Jung, Gyoo Sik

AU - Song, Ho Young

AU - Seo, Tae-Seok

AU - Park, Seon Ja

AU - Koo, Ja Young

AU - Huh, Jin Do

AU - Young, Duk Cho

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N2 - PURPOSE: To assess whether coaxial placement of uncovered and covered expandable nitinol stents overcomes the disadvantages of the increased migration rate seen with covered stents and the tumor ingrowth seen in uncovered stents in the treatment of malignant gastric outlet obstructions. Materials AND METHODS: Two types of expandable nitinol stent were designed: an uncovered stent and a covered stent. Under fluoroscopic guidance, the uncovered and covered stents were placed coaxially with complete overlap in 39 consecutive patients with malignant gastric outlet obstruction caused by stomach cancer. Food intake capacity was graded on a scale of 0-4. Stent patency rate was estimated by the Kaplan-Meier method. RESULTS: Technical success rate was 97% (38 of 39 patients). After stent placement, food intake capacity improved at least one grade in 36 patients. Stent migration occurred in three patients (8%), that is, partial (n = 2) or complete (n = 1) upward migration of the inner covered stent into the stomach. Two of these patients were treated by placement of an additional covered stent. During the mean follow-up period of 134 days (range, 15-569 d), 10 patients developed recurrent symptoms of obstruction with tumor overgrowth being the most common cause. Nine underwent placement of an additional covered stent with good results. The median period of primary stent patency was 157 days (mean, 278 d). The 30-, 60-, and 180-day patency rates were 97%, 91%, and 39%, respectively. Four patients (10%) died within 1 month after the procedure. CONCLUSION: Coaxial stent placement technique seems to contribute to decreasing the migration rate of the stent and decrease the rate of recurrent obstruction by preventing or delaying tumor ingrowth.

AB - PURPOSE: To assess whether coaxial placement of uncovered and covered expandable nitinol stents overcomes the disadvantages of the increased migration rate seen with covered stents and the tumor ingrowth seen in uncovered stents in the treatment of malignant gastric outlet obstructions. Materials AND METHODS: Two types of expandable nitinol stent were designed: an uncovered stent and a covered stent. Under fluoroscopic guidance, the uncovered and covered stents were placed coaxially with complete overlap in 39 consecutive patients with malignant gastric outlet obstruction caused by stomach cancer. Food intake capacity was graded on a scale of 0-4. Stent patency rate was estimated by the Kaplan-Meier method. RESULTS: Technical success rate was 97% (38 of 39 patients). After stent placement, food intake capacity improved at least one grade in 36 patients. Stent migration occurred in three patients (8%), that is, partial (n = 2) or complete (n = 1) upward migration of the inner covered stent into the stomach. Two of these patients were treated by placement of an additional covered stent. During the mean follow-up period of 134 days (range, 15-569 d), 10 patients developed recurrent symptoms of obstruction with tumor overgrowth being the most common cause. Nine underwent placement of an additional covered stent with good results. The median period of primary stent patency was 157 days (mean, 278 d). The 30-, 60-, and 180-day patency rates were 97%, 91%, and 39%, respectively. Four patients (10%) died within 1 month after the procedure. CONCLUSION: Coaxial stent placement technique seems to contribute to decreasing the migration rate of the stent and decrease the rate of recurrent obstruction by preventing or delaying tumor ingrowth.

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KW - Stomach, stenosis or obstruction

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