Document Detail


New ePTFE/FEP-covered stent in the palliative treatment of malignant biliary obstruction.
MedLine Citation:
PMID:  12050298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the technical efficacy and safety of an expanded polytetrafluoroethylene and fluorinated ethylene propylene (ePTFE/FEP)-covered metallic stent in the management of malignant biliary obstruction and to evaluate its clinical efficacy by estimating stent patency and patient survival rates. MATERIALS AND METHODS: Twenty-six patients with common bile duct stricture caused by malignant disease were treated by placement of 29 stents. The stent consists of an inner ePTFE/FEP lining and an outer supporting structure of nitinol wire. Multiple wire sections elevated from the external surface provide anchoring. Stents are available in two versions, with or without holes in the proximal stent lining. Holes should provide drainage of the cystic duct or biliary side branches when covered by the proximal stent end. Clinical evaluation and assessment of serum bilirubin and liver enzyme levels were done before stent placement and at 1, 3, 6, and 9 months. Average follow-up duration was 5.4 months (range, 5 d to 12.5 mo). RESULTS: Placement was successful in all cases. The 30-day mortality rate was 11.5%. The survival rates were 40% and 15% at 6 and 12 months, respectively. Eighty-four percent of patients had adequate palliative drainage during their lifetime. The stent patency rates were 91%, 77%, and 77% at 3, 6, and 12 months, respectively. Four patients (16%) presented with stent occlusion and needed repeat intervention. No migration occurred. Complications other than stent occlusion occurred in five patients (19%); among these, acute cholecystitis was observed in three patients (12%). CONCLUSION: Preliminary results suggest that placement of this ePTFE/FEP-covered stent is feasible and effective in achieving biliary drainage. The percentage of patients undergoing lifetime palliation and the midterm patency are promising. However, the incidence of acute cholecystitis is high. Treatment of a larger group of patients is mandatory to validate these long-term results.
Authors:
Mario Bezzi; Aleksejs Zolovkins; Vito Cantisani; Filippo Maria Salvatori; Michele Rossi; Fabrizio Fanelli; Plinio Rossi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  13     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-06     Completed Date:  2002-11-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  581-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Third Chair, University of Rome "La Sapienza," Policlinico Umberto I, Via Intieri 10, I-00191 Rome, Italy. mario.bezzi@uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography
Cholangiography
Cholestasis / mortality,  radiography*,  surgery*
Digestive System Diseases / pathology*
Female
Humans
Life Tables
Male
Middle Aged
Palliative Care*
Polytetrafluoroethylene* / analogs & derivatives*
Stents / adverse effects*
Survival Rate
Vascular Patency / drug effects
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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