Clinical outcomes of nitinol and stainless steel uncovered metal stents for malignant biliary strictures: Is there a difference?

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24 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1195-1200
Number of pages6
JournalGastrointestinal endoscopy
Volume72
Issue number6
DOIs
StatePublished - Dec 2010

Keywords

  • Abbreviations
  • N
  • Nitinol
  • SEMS
  • SS
  • Self-expandable metal stent
  • Stainless steel

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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