| New ePTFE/FEP-covered stent in the palliative treatment of malignant biliary obstruction. | |
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MedLine Citation:
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PMID: 12050298 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mario Bezzi; Aleksejs Zolovkins; Vito Cantisani; Filippo Maria Salvatori; Michele Rossi; Fabrizio Fanelli; Plinio Rossi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2002-06-06 Completed Date: 2002-11-26 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 581-9 Citation Subset: IM |
Affiliation:
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Department of Radiology, Third Chair, University of Rome "La Sapienza," Policlinico Umberto I, Via Intieri 10, I-00191 Rome, Italy. mario.bezzi@uniroma1.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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