Ultraflex stent

Fig. 2.5. Deployment of an Ultraflex stent. With the stent positioned across the lesion still contracted on its delivery system, the string surrounding the stent is pulled and the stent expands by its own force...

The nitinol Strecker stent was an earlier version of the uncovered Ultraflex stent and is very similar to it... 

Reported experience for the newer stent designs, such as the Flamingo and Ultraflex stents, is relatively hmited. Poyanli et al. (2001) reported good symptomatic relief and no procedure-related complications in 33 patients treated with the Flamingo stent (Poyanli et al. 2001). In a recent randomized prospective study at Guy s Hospital and St. Thomas Hospital, 37 patients were treated with Flamingo or covered Ultraflex stents. Both stents produced comparable improvements in dysphagia rehef and a similar low incidence of complications. 

Pain following stenting is common but usually resolves after a few days. Persistent severe pain occurs in a small minority of patients, and maybe related to the placement of stents in the upper esophagus. Pain is probably more common with more rigid stents such as the Gianturco stent than with softer stents such as the Ultraflex stent. However, the incidence and severity of pain related to esophageal stenting has never been assessed accurately, and its relationship has not been systematically correlated with individual stents. 

Ultraflex stents are also available with polyvinyl chloride coverage. The proximal and distal ends are uncovered in order to allow mucosal ingrowth. 

A large series of 100 Ultraflex stent insertions in 96 patients comes from two experienced airway centers (Herth et al. 2001). In all, 79 stents were placed for malignant incurable central airway diseases, the remaining indications were benign conditions. Of the 96 patients, 90 had high-grade stenoses. Stents... 

A recent study reported on the placement of 28 Ultraflex stents in 25 patients with respiratory distress due to inoperable airway obstruction (Madden et al. 2002). In this trial, 21 tracheal and seven bronchial stents were placed. The vast majority of patients received covered stents (n=21), the minority uncovered stents (n=7). Of the 25 patients, 20 reported symptomatic improvement after stent implantation. The follow-up period ranged from 3 days to 27 months. Late complications included sputum retention and infection in four patients, halitosis in one patient, and granulation tissue formation in another patient. 

Finally, the two groups from Heidelberg, Germany and Boston, MA reported successful placement of covered Ultraflex stents for sealing tracheoesophageal fistulas in ten patients. However, the authors do not report whether the fistulas were successfully sealed off (Herth et al. 2001). 

In the Japanese multicenter trial of the uncovered Ultraflex stent (Miyazawa et al. 2000), tumor ingrowth (24%) and tumor overgrowth (21%) were the most frequent complications during the 2-month follow up period. Mucus retention was noted in 9% and granuloma formation was seen in 3%. No migrations of the uncovered stents occurred. 

In the large series of 100 Ultraflex stent insertions by the group of Herth et al. (2001) and colleagues, no immediate complications were reported. Longterm results, however, are not described in the paper. 

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