Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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The Effi cacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

  • Chang, Il-Soo (Department of Radiology, Konkuk University Hospital) ;
  • Park, Sang-Woo (Department of Radiology, Konkuk University Hospital) ;
  • Hwang, Dae-Yong (Department of Surgery, Konkuk University Hospital) ;
  • Seong, Moo-Kyung (Department of Surgery, Konkuk University Hospital) ;
  • Joh, Hee-Kyung (Department of Family Medicine, Konkuk University Hospital) ;
  • Yoon, So-Young (Department of Internal Medicine, Konkuk University Hospital) ;
  • Cho, Yo-Han (Department of Internal Medicine, Konkuk University Hospital) ;
  • Choe, Won-Hyeok (Department of Internal Medicine, Konkuk University Hospital)
  • Published : 2011.02.01
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Abstract

Objective: We wanted to evaluate the effi cacy 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 fl exure 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 fl uoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon.

Keywords

References

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  2. Radiologic Placement of Uncovered Stents for the Treatment of Malignant Colonic Obstruction Proximal to the Descending Colon vol.40, pp.1, 2011, https://doi.org/10.1007/s00270-016-1474-3