Document Detail


Usefulness of a guiding sheath for fluoroscopic stent placement in patients with malignant gastroduodenal obstruction.
MedLine Citation:
PMID:  23543149     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background Self-expandable metallic stent placement is widely used to manage malignant gastroduodenal obstructions. However, there are difficulties in negotiating a guidewire (GW) and a stent delivery system (SDS). Purpose To investigate feasibility, usefulness, and safety of a guiding sheath for fluoroscopic stent placement in patients with malignant gastroduodenal obstructions. Material and Methods In July 2001 to August 2011, 726 patients with malignant gastroduodenal obstructions underwent stent placement. Guiding sheath was used in patients in whom a GW could not be passed through the obstruction and a SDS failed to reach the obstruction. Sheath usefulness was evaluated based on the ability of the sheath to successfully assist. The technical success rate and the most frequent reasons for the use of a sheath were evaluated. Results The guiding sheath was needed in 148 of 726 patients (20%). The overall technical success rate was 98% with the guiding sheath. In two of 148 patients, stent placement failed because, the GW could not be passed through the obstruction, in the other, the SDS could not be passed. A minority of patients reported mild discomfort. Patients with pancreatic cancer and duodenal obstruction were significantly more likely to require the use of guiding sheaths (P = 0.002, P < 0.001, respectively). Conclusion Using a guiding sheath for fluoroscopic stent placement appears to be feasible, useful and safe in patients with malignant gastroduodenal obstructions.
Authors:
Jung-Hoon Park; Ho-Young Song; Myoung Sun Kim; Rosa Chung; Jin Hyoung Kim; Han Kyu Na; Deok Ho Nam
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  54     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  267-71     Citation Subset:  IM    
Affiliation:
Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
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