Management of airway involvement of oesophageal cancer using covered retrievable nitinol stents

Lee, K.E.; Shin, J.H.; Song, H.Y.; Kim, S.B.; Kim, K.R.; Kim, J. Hyoung

doi:10.1016/j.crad.2008.08.001

« Previous Next »Clinical Radiology
Volume 64, Issue 2 , Pages 133-141, February 2009

Management of airway involvement of oesophageal cancer using covered retrievable nitinol stents

K.E. Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
J.H. Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Guarantor and correspondent: J. H. Shin, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. Tel.: +82-2-3010-4380; fax: +82-2-476-4719.
H.Y. Song
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
S.B. Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
K.R. Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
J. Hyoung Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Received 2 April 2008; received in revised form 18 July 2008; accepted 1 August 2008.

Aim

To assess the efficacy and safety of covered retrievable nitinol stents in oesophageal cancer patients with airway involvement.

Materials and methods

Under fluoroscopic guidance, covered retrievable nitinol airway stents were placed in 23 oesophageal cancer patients with airway stricture and/or oesophagorespiratory fistula (ERF) over a long period of 12 years. Six patients only had aspiration by ERF and three patients had both airway stricture and asymptomatic ERF. Technical aspects, dyspnoea improvement, and/or resolution of ERF symptoms, complications, reinterventions, and survival data were evaluated.

Results

A total of 27 airway stents (14 tracheal, 11 bronchial, and two hinged) were placed successfully in 23 patients with airway stricture or ERF. Dyspnoea score decreased significantly after stent placement (p<0.001). ERF were sealed off in all nine patients. Complications included stent migration or expectoration (n=4), haemoptysis (n=2), sputum retention (n=7), and tumour overgrowth (n=1). All three migrated stents were easily removed. Twenty-one patients died, with the median survival period of 76 days (range 2–197 days).

Conclusion

Placement of covered retrievable expandable nitinol stents was safe and effective for the palliative treatment of airway strictures and/or ERF, with a reasonable range of complications, in patients with advanced oesophageal cancer.