Aims:
Endoscopic placement of esophageal stents is a common procedure in the management
of benign esophageal perforations and in the management of esophageal anastomotic
leaks. One of their limitations is a high rate of stent migration. It is proposed
the use of Double-layered Covered Nitinol Stent to solve this problem.
Aims: This study reviews our experience with Double-layered Covered Nitinol Stent
(Niti-S Esophageal covered stent [Double type]®) placement in patients with benign
esophageal leaks or perforations.
Methods:
Retrospective, descriptive, and single-center study including patients with esophageal
leaks or perforations, between January 2010 and July 2017. Data was extracted from
medical history. The main objective is to evaluate the clinical success of the intervention.
Clinical success was defined as leak or perforation closure after stent removal as
confirmed by endoscopy, without surgical intervention. As secondary objective, the
presence of post-procedure complications was analyzed, emphasizing the stent's migration
rate. Stent migration was classified in partial and complete: partial stent migration,
when endoscopic stent reposition was possible; complete stent migration, when it was
necessary to place a new one.
Results:
Following the exclusion criteria, a total of 13 patients were included. The clinical
success rate after first stent removal was 77% (n = 10), and up to 92% (n = 12) in
the case of second stenting. The medium stenting time was 42 days. In terms of complications,
3 cases were registered; all were due to partial stent migration, that occurred within
a medium of 8.66 days.
Conclusions:
According to our data, use of double-layered covered stents is a therapeutic alternative
in esophageal leaks and perforations, with a high success rate and low rate of complications.
In our study, all stent migrations were solved by stent reposition, without the need
of a new stent placement or surgery.
