[Percutaneous therapy of inoperable biliary stenoses and occlusions with a new self-expanding nitinol stent (SMART)].
OBJECTIVE
To evaluate the treatment of malignant biliary stenoses and occlusions using a new stent.


METHODS
In a prospective study, 25 patients with malignant obstructive jaundice were treated with SMART(R) stents. The handling and the quality of stent expansion were documented. Stent function was assessed 2 - 4 days after intervention by cholangiography and laboratory tests. A follow-up was performed three months, after stent placement.


RESULTS
All lesions were treated successfully, with a total of 35 stents implanted. In 14 patients a further balloon dilatation was performed after stent placement (8 - 10 mm diameter/ 40 - 80 mm length). The mean serum bilirubin level decreased significantly from 11.6 mg/dl to 4.6 mg/dl after intervention (p < 0.05). The follow-up showed a mean serum bilirubin level at 4.0 mg/dl. In 4 cases (16 %) a further intervention (PTCD or stent) was performed. Six patients died due to tumor progression. The stents proved to be patent in 79 % (n = 15) of patients alive at the time of follow-up.


CONCLUSIONS
Placement of the SMART stent for the therapy of malignant biliary lesions yields good technical and clinical results.
Zorger
N
N
Institut für Röntgendiagnostik, Klinikum der Universität Regensburg. nielszorger@aol.com
Lenhart
M
M
Strotzer
M
M
Paetzel
C
C
Hamer
O
O
Feuerbach
S
S
Link
J
J
D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001663:Bilirubin / Q000097:blood; D001943:Breast Neoplasms / Q000150:complications; D006528:Carcinoma, Hepatocellular / Q000150:complications; D002779:Cholestasis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018285:Klatskin Tumor / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D011446:Prospective Studies; D011859:Radiography; D012086:Reoperation; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D013997:Time Factors
D000497:Alloys; C013616:nitinol; D001663:Bilirubin