TY - JOUR
T1 - Clinical outcomes of nitinol and stainless steel uncovered metal stents for malignant biliary strictures
T2 - Is there a difference?
AU - Weston, Brian R.
AU - Ross, William A.
AU - Liu, Jun
AU - Lee, Jeffrey H.
PY - 2010/12
Y1 - 2010/12
N2 - Background Self-expandable metal stents (SEMSs) made from nitinol (N) were developed as a potentially more effective alternative to conventional stainless steel (SS) stents. Objective To compare clinical outcomes of N versus SS stents in the management of malignant biliary strictures. Design Retrospective study. Setting Tertiary-care cancer center. Patients All patients with first-time N (Flexxus) and SS (Wallstent) uncovered biliary SEMSs placed between January 2006 and October 2007. Interventions SEMS placement. Results A total of 81 N and 96 SS stents were placed. The most common cancer diagnosis was pancreatic (80.2% N; 62.5% SS; P = .06). The most frequent site of stricture was the common bile duct (85.2% N; 86.5% SS; P = .31). Biliary decompression was achieved in 93.8% of the N group and 86.4% of the SS group (P = .22). Immediate stent manipulation was required in 4 patients in each group. Subsequent intervention for poor drainage was performed in 17 N (21%) and 26 SS (27%) stents at mean times of 142.1 days (range, 5-541 days; median, 77 days) and 148.1 days (range, 14-375; median, 158.5), respectively (P = .17). The occlusion rate between N and SS stents was not significant (P = .42). The overall durations of stent patency in the N and SS group were similar (median 129 and 137 days, respectively; P = .61), including the subgroup analysis performed on patients with pancreatic cancer (P = .60) and common duct strictures (P = .77). Complication rates were low in both groups (early: 3.7% N, 6.3% SS; late: 2.5% N, 3.1% SS). Ninety percent underwent chemotherapy and 38% radiation therapy in each group. Limitations Retrospective design. Conclusion Similar outcomes were achieved with N and SS stents regarding efficacy, duration of stent patency, occlusion rates, and complications. Our results are most applicable to patients with common duct strictures and pancreatic cancer.
AB - Background Self-expandable metal stents (SEMSs) made from nitinol (N) were developed as a potentially more effective alternative to conventional stainless steel (SS) stents. Objective To compare clinical outcomes of N versus SS stents in the management of malignant biliary strictures. Design Retrospective study. Setting Tertiary-care cancer center. Patients All patients with first-time N (Flexxus) and SS (Wallstent) uncovered biliary SEMSs placed between January 2006 and October 2007. Interventions SEMS placement. Results A total of 81 N and 96 SS stents were placed. The most common cancer diagnosis was pancreatic (80.2% N; 62.5% SS; P = .06). The most frequent site of stricture was the common bile duct (85.2% N; 86.5% SS; P = .31). Biliary decompression was achieved in 93.8% of the N group and 86.4% of the SS group (P = .22). Immediate stent manipulation was required in 4 patients in each group. Subsequent intervention for poor drainage was performed in 17 N (21%) and 26 SS (27%) stents at mean times of 142.1 days (range, 5-541 days; median, 77 days) and 148.1 days (range, 14-375; median, 158.5), respectively (P = .17). The occlusion rate between N and SS stents was not significant (P = .42). The overall durations of stent patency in the N and SS group were similar (median 129 and 137 days, respectively; P = .61), including the subgroup analysis performed on patients with pancreatic cancer (P = .60) and common duct strictures (P = .77). Complication rates were low in both groups (early: 3.7% N, 6.3% SS; late: 2.5% N, 3.1% SS). Ninety percent underwent chemotherapy and 38% radiation therapy in each group. Limitations Retrospective design. Conclusion Similar outcomes were achieved with N and SS stents regarding efficacy, duration of stent patency, occlusion rates, and complications. Our results are most applicable to patients with common duct strictures and pancreatic cancer.
KW - Abbreviations
KW - N
KW - Nitinol
KW - SEMS
KW - SS
KW - Self-expandable metal stent
KW - Stainless steel
UR - http://www.scopus.com/inward/record.url?scp=78649522136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78649522136&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2010.08.035
DO - 10.1016/j.gie.2010.08.035
M3 - Article
C2 - 21111871
AN - SCOPUS:78649522136
SN - 0016-5107
VL - 72
SP - 1195
EP - 1200
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 6
ER -