Korean J Radiol.  2012 Feb;13(1):66-72. 10.3348/kjr.2012.13.1.66.

Dual-Design Expandable Colorectal Stent for a Malignant Colorectal Obstruction: Preliminary Prospective Study Using New 20-mm Diameter Stents

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. hysong@amc.seoul.kr
  • 2Department of Radiology & Imaging, Queen Elizabeth Hospital, Kowloon, Hong Kong.
  • 3Department of Microbiology, Bio-Medical Institute Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
  • 4Department of Colorectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.

Abstract


OBJECTIVE
To evaluate the safety and effectiveness of a 20-mm diameter dual-design expandable colorectal stent for malignant colorectal obstruction.
MATERIALS AND METHODS
The study series included 34 patients with malignant colorectal obstruction who underwent implantation of a 20-mm dual-design expandable colorectal stent in our department between March 2009 and June 2010. The 20-mm dual-design expandable colorectal stent was placed by using a 3.8-mm delivery system that had 28-mm diameter proximal and distal ends. Among the 34 patients, stent placement for palliation was performed in 20 patients, while stent placement for bridge to surgery was performed in 14 patients.
RESULTS
A 97% (33 of 34) success rate was achieved for the stent placement. The perforation rate in the bridge to surgery group was 7% (1 of 14), compared to 0% (0 of 19) in palliative group. Migration occurred in one of 33 patients (3%) at 30 days after stent placement.
CONCLUSION
The placement of a 20-mm diameter dual-design stent appears to be clinically safe and effective for the management of colorectal obstruction, with low perforation and migration rates.

Keyword

Colorectal cancer; Stent; Dual-design; Expandable

MeSH Terms

Adult
Aged
Aged, 80 and over
Colorectal Neoplasms/*complications
Female
Foreign-Body Migration/etiology
Humans
Intestinal Obstruction/*etiology/*therapy
Intestinal Perforation/etiology
Male
Middle Aged
Palliative Care
Prospective Studies
Prosthesis Design
*Stents
Treatment Outcome

Figure

  • Fig. 1 Photograph showing, from top to bottom, outer stent of dual stent, inner bare nitinol stent of dual stent, and bended inner bare nitinol stent.

  • Fig. 2 Illustration of patient with sigmoid colon cancer (patient 11). A. Water-soluble contrast study with sizing coil catheter during stent placement showing incomplete colonic obstruction. B. Plain radiograph obtained during placement of dual stent showing loaded distal stent. C. Plain radiograph obtained immediately after outer stent placement with loaded inner stent. D. Plain radiograph obtained immediately after stent placement of dual stent showing good flow of contrast medium through stent.


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