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Two fatal complications after parallel tracheal-esophageal stenting
Christoph A Binkert1, Bryan D Petersen
1Dotter Interventional Institute, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098, USA. Binkert@compuserve.com
Cardiovascular and Interventional Radiology
|March 20, 2002
Summary
Gianturco-Rösch Z (GRZ) stents are risky for parallel tracheal-esophageal placement. This technique can cause fatal hemorrhage due to stent pressure and tissue erosion.
Area of Science:
- Medical Devices
- Gastroenterology
- Pulmonology
Background:
- Malignant obstructions in both the trachea and esophagus often require palliative interventions.
- Gianturco-Rösch Z (GRZ) stents are commonly used for solitary tracheal or esophageal stenoses.
Observation:
- Two patients with malignant obstructions underwent parallel stent placement using GRZ stents.
- Both patients experienced fatal hemorrhage 2 and 3 weeks post-procedure.
Findings:
- Autopsy revealed esophageal tissue necrosis and perforation where parallel GRZ stent struts opposed.
- This erosion led to bleeding from the esophageal venous plexus.
Implications:
- Parallel stenting with GRZ stents in the trachea and esophagus carries a high risk of fatal hemorrhage.
- The radial force of GRZ stents and minimal intervening tissue contribute to this complication.