Use of peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures.
OBJECTIVE
To report the initial and midterm results of percutaneous cutting balloon incision and dilation (PCBID) for the treatment of benign ureteral and biliary strictures in patients after failed high-pressure balloon dilation.


METHODS
The study sample consisted of 11 patients: three with ureteric strictures after renal transplantation, three with biliary anastomotic strictures after liver transplantation, three with pelvic metastatic disease compressing the ureter, one after a failed endoscopic papilla of Vater sphincterotomy, and one with tight stenosis at the choledochojejunal anastomosis. All strictures were resistant to high-pressure balloon dilation. Four patients underwent PCBID immediately after failed high-pressure balloon dilation in the same session, and seven underwent the procedure in a separate session within the subsequent week. The width of the peripheral cutting balloons did not exceed the diameter of the normal lumen (7-8 mm).


RESULTS
PCBID was successful in nine patients (82%). One failure occurred in a transplanted ureter and one occurred in a transplanted liver with a choledochocholedochal anastomosis. In both cases, PBCID was performed in the same session as failed high-pressure balloon dilation. There were no periprocedural complications. Patency was confirmed at the 3- and 6-month clinical and ultrasonographic follow-up.


CONCLUSIONS
PCBID is a simple minimally invasive method for the treatment of benign ureteric and biliary strictures. The success rate is high and no complications occurred.
Atar
Eli
E
Department of Diagnostic Radiology, Unit of Vascular and Interventional Radiology, Rabin Medical Center, Golda Campus, Petah Tikva 49372, Israel. atareli@hotmail.com
Bachar
Gil N
GN
Bartal
Gabriel
G
Mor
Eitan
E
Neyman
Haim
H
Graif
Franklyn
F
Belenky
Alexander
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001649:Bile Duct Diseases / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D003135:Common Bile Duct / Q000601:surgery; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000556:secondary; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014515:Ureteral Diseases / Q000628:therapy*