Korean J Radiol.  2007 Feb;8(1):57-63. 10.3348/kjr.2007.8.1.57.

Interventional Management of Malignant Colorectal Obstruction: Use of Covered and Uncovered Stents

• Choi JS
• Choo SW
• Park KB
• Shin SW
• Yoo SY
• Kim JH
• Do YS

• KMID: 753866
• DOI: http://doi.org/10.3348/kjr.2007.8.1.57

Abstract

Objective
We wanted to evaluate usefulness of uncovered stent in comparison with covered stent for the palliative treatment of malignant colorectal obstruction. Materials and Methods: Covered (n = 52, type 1 and type 2) and uncovered (n = 22, type 3) stents were placed in 74 patients with malignant colorectal obstruction. Stent insertion was performed for palliative treatment in 37 patients (covered stent: n = 23 and uncovered stent: n = 14). In the palliative group, the data on the success of the procedure, the stent patency and the complications between the two groups (covered versus uncovered stents) were compared. Results: The technical success rate was 89% (33/37). Symptomatic improvement was achieved in 86% (18/21) of the covered stent group and in 92% (11/12) of the uncovered stent group patients. The period of follow-up ranged from three to 319 days (mean period: 116+/-85 days). The mean period of stent patency was 157+/-33 days in the covered stent group and 165+/-25 days in the uncovered stent group. In the covered stent group, stent migration (n = 11), stent fracture (n = 2) and poor expansion of the stent (n = 2) were noted. In the uncovered stent group, tumor ingrowth into the stents (n = 3) was noted. Conclusion: Self-expanding metallic stents are effective for relieving malignant colorectal obstruction. The rate of complications is lower in the uncovered stent group than in the covered stent group.

Keyword

Colon, interventional procedures; Colon, neoplasm; Colon, stenosis or obstruction; Stents and prostheses

MeSH Terms

Treatment Outcome
Tomography, X-Ray Computed
*Stents
*Radiography, Interventional
Palliative Care
Middle Aged
Male
Intestinal Obstruction/*etiology/radiography/*therapy
Humans
Female
Equipment Design
Colorectal Neoplasms/*complications/radiography/*therapy
Aged, 80 and over
Aged
Adult

Figure

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  Fig. 1 Type 1 (A), type 2 (B) and type 3 (C) stents. To prevention migration, two-thirds of the proximal part of the type 2 stent is not covered (arrowheads).

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  Fig. 2 Stent fracture of the type 2 stent in a 64-year-old patient. 180 days after stent insertion, the stent broke between the proximal end and the body (arrows).

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  Fig. 3 Inadequate expansion of the type 2 stent in a 60-year-old patient. Seven days after insertion, inadequate expansion of the stent was noted.

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  Fig. 4 Tumor ingrowth of the type 3 stent in a 65-year-old patient. 135 days after stent insertion, tumor ingrowth on the CT scan was seen (arrows). No symptomatic bowel obstruction was noted until the patient's death.

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