# Efficacy of a higher-flexibility duodenal stent for palliation of gastric outlet obstruction

## TL;DR

A new flexible duodenal stent was found to be effective in relieving stomach blockage symptoms with fewer side effects compared to older stents.

## Contribution

The study introduces a higher-flexibility duodenal stent with improved clinical outcomes and safety in palliative care.

## Key findings

- The WallFlex Duodenal Soft stent achieved 100% technical and 82% clinical success in treating gastric outlet obstruction.
- Patients with the new stent had longer symptom-free survival (83 days) and lower adverse event rates (18%) compared to older stents.
- Overall survival was 101 days for the new stent versus 82 days for other stents.

## Abstract

Duodenal self-expandable metallic stent (SEMS) placement is a common palliative treatment for malignant gastric outlet obstruction symptoms (GOOS). The higher flexibility of the WallFlex Duodenal Soft stent aims to ease stent placement and reduce adverse events (AE). This descriptive study compared the WallFlex Soft stent with other duodenal SEMS designs with regard to efficacy and safety.

Patients receiving the WallFlex Duodenal Soft stent as first-line treatment for GOOS were included in a prospective cohort (2019–2023). A retrospective cohort (1998–2019) with patients treated with other duodenal SEMS designs as first-line treatment for GOOS was used for comparison.

In the prospective cohort, 11 patients were treated with the WallFlex Duodenal Soft, achieving 100% technical and 82% clinical success rates. The retrospective cohort of 147 patients with various types of duodenal SEMS showed 97% technical and 86% clinical success. For the WallFlex Duodenal Soft vs. the other duodenal SEMS, the overall survival was 101 vs. 82 days and median symptom-free survival was 83 vs. 28 days. AE rates were 18% vs. 28%, respectively.

The WallFlex Duodenal Soft stent effectively treats GOOS in palliative patients and seems to be associated with longer symptom-free survival and lower AE rates compared with previous duodenal SEMS designs.