Song H Y, Park S I, Jung H Y, Kim S B, Kim J H, Huh S J, Kim T H, Kim Y K, Park S, Yoon H K, Sung K B, Min Y I
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-Ku, Seoul, Korea.
Radiology. 1997 Jun;203(3):747-52. doi: 10.1148/radiology.203.3.9169699.
To evaluate the clinical effectiveness of a polyurethane-covered, retrievable, self-expandable metallic stent and hook catheter in the treatment of esophageal strictures.
Stents were constructed of 0.4-mm stainless steel wire in a cylindric zig-zag configuration of six to nine bends. Four to eight stents were connected in tandem by dipping in a polyurethane solution. A nylon loop was hooked inside to each bend of the proximal portion of the stent and strung with a thread. Under fluoroscopic guidance, 22 stents were placed in 16 patients with a malignant stricture and five patients with a benign stricture. The stent was removed with a hook catheter 2 months after placement in patients with a benign stricture and when complications occurred in patients with a malignant stricture. All patients had dysphagia with ingestion of soft foods or liquids.
Stent placement was technically successful and well tolerated in 20 patients. In one patient, the stent was misplaced but relocated successfully. After stent placement, all patients were able to ingest solid and/or soft foods without dysphagia. After stent removal, strictures showed improvement but recurred in two patients.
Use of polyurethane-covered, retrievable expandable stents seems to be a feasible and effective method of treatment of benign and malignant esophageal strictures.
评估一种聚氨酯涂层、可回收、自膨胀金属支架及钩形导管治疗食管狭窄的临床疗效。
支架由0.4毫米不锈钢丝制成，呈六至九个弯曲的圆柱形之字形结构。将四至八个支架串联在一起，浸入聚氨酯溶液中。在支架近端的每个弯曲处内部钩入一个尼龙环并用线串起来。在荧光透视引导下，将22个支架置入16例恶性狭窄患者和5例良性狭窄患者体内。良性狭窄患者在支架置入2个月后以及恶性狭窄患者出现并发症时，用钩形导管取出支架。所有患者均有吞咽软食或液体时的吞咽困难。
20例患者支架置入技术成功且耐受性良好。1例患者支架放置位置不当，但成功重新定位。支架置入后，所有患者均能吞咽固体和/或软食而无吞咽困难。支架取出后，狭窄有所改善，但2例患者复发。
使用聚氨酯涂层、可回收的可膨胀支架似乎是治疗良性和恶性食管狭窄的一种可行且有效的方法。
