Fluoroscopically guided placement of a covered self-expandable metallic stent for malignant antroduodenal obstructions: preliminary results in 18 patients.
OBJECTIVE
The purpose of this study was to investigate the technical feasibility and the clinical effectiveness of fluoroscopically guided placement of covered self-expandable metallic stents in the treatment of malignant antroduodenal obstructions.


METHODS
With fluoroscopic guidance, covered self-expandable metallic stents were placed in 18 consecutive patients with inoperable malignant antroduodenal obstructions. All patients were treated for severe nausea and recurrent vomiting.


RESULTS
Stent placement was technically successful in all patients with or without gastrostomy (n = 2) and balloon dilatation (n = 3). After stent placement, symptoms improved in all but one patient, who had another stenosis in the proximal jejunum. During the follow-up of 2-73 weeks (mean, 12 weeks), stent migration occurred in three patients (16.7%) from 1 to 41 days after the procedure. These patients were treated successfully by means of placing a second covered metallic stent. Two patients, who were followed up for longer than 30 weeks, showed a recurrence of strictures because of mechanical failure of the stents; one of the patients was treated with coaxial placement of a second covered metallic stent, which had a positive clinical outcome.


CONCLUSIONS
Fluoroscopically guided placement of covered self-expandable metallic stents is technically feasible and effective for the palliative treatment of inoperable malignant antroduodenal obstructions. The rate of stent migration in our study was lower than those in previous reports.
Jeong
Jun Yong
JY
Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Han
Joon Koo
JK
Kim
Ah Young
AY
Lee
Kyoung Ho
KH
Lee
Jae Young
JY
Kang
Joon-Won
JW
Kim
Tae Jung
TJ
Shin
Shang Hoon
SH
Choi
Byung Ihn
BI
D000328:Adult; D000368:Aged; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015641:Radiography, Interventional; D015607:Stents