$ WallFlex^{®} $ and $ Evolution^{®} $ Duodenal Stents Have Similar Efficacy but Different Safety for Malignant Gastric Outlet Obstruction
Background The $ WallFlex^{®} $ and $ Evolution^{®} $ stents are the most widely used duodenal stents, but no study has compared them. Aims We aimed to compare the efficacy and safety of $ WallFlex^{®} $ and $ Evolution^{®} $ stents for malignant gastric outlet obstruction. Methods We included all consecutive patients who were treated for malignant gastric outlet obstruction with $ WallFlex^{®} $ or $ Evolution^{®} $ self-expandable metal uncovered duodenal stents between 2013 and 2020. Multivariable Cox models were performed to assess duodenal stent failure, as defined by gastric outlet obstruction necessitating another duodenal stent. Results We included 129 patients: 74 received a $ WallFlex^{®} $ stent and 55 received an $ Evolution^{®} $ stent. The non-failure rate was of 68% (95%CI 55–84) and 65% (95%CI 50–84) at 6 months and of 48% (95%CI 32–73) and 45% (95%CI 27–74) at 1 year, with the $ WallFlex^{®} $ and $ Evolution^{®} $ stents, respectively. The median time to duodenal stent failure was 10.5 months in the $ WallFlex^{®} $ group and 9.3 months in the $ Evolution^{®} $ group. The type of duodenal stent was not associated with duodenal stent failure (p logrank = 0.43, adjusted hazard ratio 1.55; 95%CI 0.77–3.14). The overall survival was similar between the two groups (p logrank = 0.92). Three patients had complications due to $ Evolution^{®} $ stents; it consisted in dismantled stents that led to hemorrhage in one patient. Conclusions $ WallFlex^{®} $ and $ Evolution^{®} $ duodenal stents had similar efficacy for malignant gastric outlet obstruction. There were more adverse events with $ Evolution^{®} $ stents..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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Enthalten in: |
Digestive diseases and sciences - 68(2023), 9 vom: 21. Juli, Seite 3688-3693 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Meyer, Antoine [VerfasserIn] |
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Links: |
Volltext [lizenzpflichtig] |
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Themen: |
Duodenal stent |
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Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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doi: |
10.1007/s10620-023-08036-7 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
SPR052824942 |
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520 | |a Background The $ WallFlex^{®} $ and $ Evolution^{®} $ stents are the most widely used duodenal stents, but no study has compared them. Aims We aimed to compare the efficacy and safety of $ WallFlex^{®} $ and $ Evolution^{®} $ stents for malignant gastric outlet obstruction. Methods We included all consecutive patients who were treated for malignant gastric outlet obstruction with $ WallFlex^{®} $ or $ Evolution^{®} $ self-expandable metal uncovered duodenal stents between 2013 and 2020. Multivariable Cox models were performed to assess duodenal stent failure, as defined by gastric outlet obstruction necessitating another duodenal stent. Results We included 129 patients: 74 received a $ WallFlex^{®} $ stent and 55 received an $ Evolution^{®} $ stent. The non-failure rate was of 68% (95%CI 55–84) and 65% (95%CI 50–84) at 6 months and of 48% (95%CI 32–73) and 45% (95%CI 27–74) at 1 year, with the $ WallFlex^{®} $ and $ Evolution^{®} $ stents, respectively. The median time to duodenal stent failure was 10.5 months in the $ WallFlex^{®} $ group and 9.3 months in the $ Evolution^{®} $ group. The type of duodenal stent was not associated with duodenal stent failure (p logrank = 0.43, adjusted hazard ratio 1.55; 95%CI 0.77–3.14). The overall survival was similar between the two groups (p logrank = 0.92). Three patients had complications due to $ Evolution^{®} $ stents; it consisted in dismantled stents that led to hemorrhage in one patient. Conclusions $ WallFlex^{®} $ and $ Evolution^{®} $ duodenal stents had similar efficacy for malignant gastric outlet obstruction. There were more adverse events with $ Evolution^{®} $ stents. | ||
650 | 4 | |a WallFlex |7 (dpeaa)DE-He213 | |
650 | 4 | |a Evolution |7 (dpeaa)DE-He213 | |
650 | 4 | |a Duodenal stent |7 (dpeaa)DE-He213 | |
650 | 4 | |a Malignancy |7 (dpeaa)DE-He213 | |
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700 | 1 | |a Carbonnel, Franck |0 (orcid)0000-0002-4779-5168 |4 aut | |
700 | 1 | |a Boytchev, Isabelle |4 aut | |
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