The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon.
10.3348/kjr.2011.12.1.107
- Author:
Il Soo CHANG
1
;
Sang Woo PARK
;
Dae Yong HWANG
;
Moo Kyung SEONG
;
Hee Kyung JOH
;
So Young YOON
;
Yo Han CHO
;
Won Hyeok CHOE
Author Information
1. Department of Radiology, Konkuk University Hospital, Seoul 143-729, Korea. psw0224@kuh.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Colon;
Stent;
Intervention;
Fluoroscopy
- MeSH:
Adult;
Aged;
Aged, 80 and over;
*Catheters;
*Colon, Descending;
Colonic Diseases/etiology/*therapy;
Colonic Neoplasms/complications;
Female;
*Fluoroscopy;
Humans;
Intestinal Obstruction/etiology/*therapy;
Male;
Middle Aged;
*Radiography, Interventional;
*Stents
- From:Korean Journal of Radiology
2011;12(1):107-112
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. MATERIALS AND METHODS: Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. RESULTS: Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4; mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. CONCLUSION: The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon.
