Self-expandable metal stents.

Self-expandable metal stents are indicated for the palliation of oesophageal and biliary malignant strictures. In these indications, the main advantages of metal over plastic stents are a lower incidence of complications associated with the placement procedure (oesophageal stents) and a longer stent patency duration (biliary stents). This article describes the different models of metal stent currently available and their insertion techniques. Clinical results reported with every stent model are reviewed, particular emphasis being placed on 'global success', defined as the proportion of patients who require no endoscopic (or percutaneous) intervention after stent insertion, up to death. Recommendations for choosing between the numerous models available are inferred from this literature review and from our clinical experience.