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Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts in the treatment of acute malignant colorectal obstruction.

Authors
 Honsoul Kim  ;  Seung Hyoung Kim  ;  Sun Young Choi  ;  Kwang-Hun Lee  ;  Jong Yoon Won  ;  Do Yun Lee  ;  Jong Tae Lee 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.19(12) : 1709-1716, 2008 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Catheterization/adverse effects ; Catheterization/instrumentation* ; Colonic Diseases/diagnostic imaging ; Colonic Diseases/etiology ; Colonic Diseases/therapy* ; Colorectal Neoplasms/complications* ; Feasibility Studies ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Intestinal Obstruction/therapy* ; Male ; Metals* ; Middle Aged ; Palliative Care ; Prosthesis Design ; Radiography, Interventional* ; Rectal Diseases/diagnostic imaging ; Rectal Diseases/etiology ; Rectal Diseases/therapy* ; Retrospective Studies ; Stents* ; Treatment Outcome
Keywords
Adult ; Aged ; Aged, 80 and over ; Catheterization/adverse effects ; Catheterization/instrumentation* ; Colonic Diseases/diagnostic imaging ; Colonic Diseases/etiology ; Colonic Diseases/therapy* ; Colorectal Neoplasms/complications* ; Feasibility Studies ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Intestinal Obstruction/therapy* ; Male ; Metals* ; Middle Aged ; Palliative Care ; Prosthesis Design ; Radiography, Interventional* ; Rectal Diseases/diagnostic imaging ; Rectal Diseases/etiology ; Rectal Diseases/therapy* ; Retrospective Studies ; Stents* ; Treatment Outcome
Abstract
PURPOSE: To evaluate the technical feasibility and clinical effectiveness of fluoroscopically guided placement of self-expandable metallic stents and stent-grafts for acute malignant colorectal obstruction. MATERIALS AND METHODS: Radiologic images and clinical reports of 42 patients (22 men, 20 women; age range, 28-93 years; median age, 65.5 years) who underwent fluoroscopically guided colorectal stent insertion without endoscopic assistance for acute malignant obstruction were reviewed retrospectively. Eighteen patients received bare stents as a bridge to surgery. Twenty-four patients received 27 insertions of either a bare stent (n = 15) or a stent-graft (n = 12) for palliation. The obstruction was located in the rectum (n = 8), sigmoid (n = 17), descending colon (n = 8), splenic flexure (n = 3), and transverse colon (n = 6). RESULTS: Clinical success, defined as more than 50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 41 of the 42 patients (98%). No major procedure-related complications occurred. Minor complications occurred in eight of the 45 procedures (18%). No perioperative mortalities occurred within 1 month after surgery. In the palliative group, the median stent patency was 62 days (range, 0-1,014 days). There was no statistically significant difference in stent patency between the bare stents (range, 0-855 days; median, 68 days) and stent-grafts (range, 1-1,014 days; median, 81 days). CONCLUSIONS: Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts for the relief of acute malignant colorectal obstruction was technically feasible without endoscopic assistance-even in lesions proximal to the splenic flexure and transverse colon-and clinically effective in both bridge to surgery and palliative management.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044308007537
DOI
10.1016/j.jvir.2008.08.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Lee, Jong Tae(이종태)
Choi, Sun Young(최선영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107890
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