CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(06): E751-E756
DOI: 10.1055/a-0890-3284
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Fully-covered esophageal stent migration rates in benign and malignant disease: a multicenter retrospective study

Samuel Thomas
1   Department of Gastroenterology and Hepatology, University of Utah - Huntsman Cancer Center, Salt Lake City, Utah, United States
,
Ali A. Siddiqui
2   Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States
,
Linda Jo Taylor
1   Department of Gastroenterology and Hepatology, University of Utah - Huntsman Cancer Center, Salt Lake City, Utah, United States
,
Sheeva Parbhu
1   Department of Gastroenterology and Hepatology, University of Utah - Huntsman Cancer Center, Salt Lake City, Utah, United States
,
Christopher Cao
2   Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States
,
David Loren
2   Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States
,
Thomas Kowalski
2   Department of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, United States
,
Douglas G. Adler
1   Department of Gastroenterology and Hepatology, University of Utah - Huntsman Cancer Center, Salt Lake City, Utah, United States
› Author Affiliations
Further Information

Publication History

submitted: 26 October 2018

accepted after revision: 26 February 2019

Publication Date:
17 May 2019 (online)

Abstract

Background and study aims Stent migration is a common complication of fully-covered self-expanding metal stents (FCSEMS), but the rate of clinically relevant migration as defined by stent migration followed by reintervention via endoscopy for stent replacement is unknown. The goal of this study is to gain insight into the total migration rate and clinically relevant migration rate of different types of FCSEMS placed within benign and malignant strictures with specific attention paid to stent manufacturer, diameter, and length.

Patients and methods Multicenter retrospective analysis of endoscopic data from patients with FCSEMS placed within benign or malignant strictures. FCSEMS used included a variety of sizes and manufacturers.

Results A total of 369 patients were included, 161 of whom had benign strictures and 208 of whom had malignant strictures. The total migration rate and clinically relevant migration rate in benign strictures were 30 % and 17 %, respectively. For benign strictures, Wallflex stents had a clinically relevant migration rate of 15 %, compared to Endomaxx stents with 19 %, and Evolution stents with 25 % (P = 0.52). The total migration rate and clinically relevant migration rates in malignant strictures were 23 % and 14 %, respectively. Evolution stents had a significantly higher clinically relevant migration rate (29 %) than the Wallflex stents (7 %) and the endomaxx stents (12 %), P = 0.003.

Conclusion This study is the largest to investigate migration rates for FCSEMS in benign and malignant strictures. Clinically relevant migration is a relatively common occurrence with all stent types studied and better anti-migration features are needed.

 
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