Self-Expanding Metallic Coil Stents for Palliation of Esophageal Carcinoma: Two Cases of Decisive Stent Dysfunction

Abstract

Two cases of different dysfunctions of self-expanding nickel-titanium coil stents are described here. In the first case, a metallic coil stent was placed in a 8-cm circular rigid stenosis of the mid-esophagus caused by a squamous-cell carcinoma (T3 N1 M1), and seven weeks later, the stent lumen was completely occluded by massive tumor ingrowth through inadequately adapted single coil wires. In the second case, the caudal and cranial ends of the stent became increasingly invaginated after initially adequate stent expansion, resulting in a shortening of the stent to about two-thirds of its intended size, with subsequent complete luminal obstruction at both ends of the stent due to tumor overgrowth. These two examples of different stent dysfunction correspond to similar observations by other investigators. Further investigations in a large series of stent insertions have to be performed before general conclusion can be drawn as to the clinical efficacy of metallic coil stents for endoscopic palliation of esophageal carcinoma.