Esophageal self-expandable metallic stents--indications, practice, techniques, and complications: results of a national survey

Gastrointest Endosc. 1997 May;45(5):360-4. doi: 10.1016/s0016-5107(97)70144-5.


Background: The gastroenterology community's experience with esophageal self-expandable metallic stents (SEMS) is unknown.

Methods: In order to assess indications, perioperative management, and self-reported complications associated with SEMS placement, a survey was mailed to ASGE members.

Results: Of 3414 surveys mailed, 212 (6.2%) were completed and returned. One hundred twenty-eight physicians had experience with a total of 434 SEMS. Most physicians practiced in the private sector (72%), and 75% had placed 3 or fewer SEMS. Perceived ease of placement was the most common reason for choosing a SEMS (55%). Fluoroscopic and endoscopic guidance was used by 83% of respondents, and 81% allowed liquid diet after correct position and patency had been confirmed; 56% of respondents discharged their patients within 24 hours of SEMS placement. The rates of failure for full expansion (7.1%), stent misplacement (4.8%), and failure to deploy (3%) were higher than previously reported. Acute patient complications and delayed bleeding occurred less frequently than in reported series but mortality rates were similar.

Conclusions: Ease of placement is the main reason for choosing a SEMS. Differences in complication rates, compared to previous studies on SEMS, may be related to operator experience and protocol requirements. When compared to plastic stents, complications were less frequent.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Equipment Design
  • Equipment Failure
  • Esophagus / surgery*
  • Humans
  • Random Allocation
  • Stents / adverse effects
  • Stents / statistics & numerical data*
  • Surveys and Questionnaires
  • United States