Document Detail


Late migration of two covered biliary stents through a spontaneous bilioenteric fistula in a patient with malignant biliary obstruction.
MedLine Citation:
PMID:  17593425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of simultaneous late migration of two ePTFE-FEP covered biliary endoprostheses (Viabil, W.L. Gore, Flagstaff, AZ, USA) that were percutaneously implanted for the treatment of malignant obstructive jaundice. The first Viabil covered stent was placed successfully without any evidence of dislocation or other complication during follow-up. Occlusion of the stent occurred 4 months later and was treated with the placement of a second stent of the same type. Thirteen months later the patient became symptomatic. Percutaneous transhepatic cholangiography (PTC) revealed the presence of a choledocho-duodenal fistula and the disappearance of the two endoprostheses previously implanted. A third metallic stent was then percutaneously positioned through the bilioenteric fistula. The computed tomography scan that followed for the detection of the metallic bodies did not reveal the dislocated metallic stents. Stent migration is a well-known complication of uncovered metallic stents, though Viabil stent migration is assumed to be most unlikely to happen due to the stent's anchoring barbs. Furthermore, the stent had already been tightly fixed by tumor over- and ingrowth, as recognized in previous imaging. This is a very unusual case, describing the disappearance of two metallic foreign bodies encapsulated by tumor.
Authors:
Miltiadis E Krokidis; Adam A Hatzidakis; Eirini G Manousaki; Nicholas C Gourtsoyiannis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  31     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-01-10     Completed Date:  2008-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Affiliation:
Department of Radiology, University Hospital of Heraklion, 71500 Heraklion-Stavrakia, Crete, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biliary Fistula / complications*
Biliary Tract / radiography
Biliary Tract Neoplasms / surgery*
Cholangiography
Duodenum / radiography
Foreign-Body Migration / etiology*
Humans
Intestinal Fistula / complications*
Male
Polytetrafluoroethylene / analogs & derivatives
Prosthesis Failure*
Reoperation
Stents / adverse effects*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/fluorinated ethylene propylene; 9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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