title: Use of peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, Unit of Vascular and Interventional Radiology, Rabin Medical Center, Golda Campus, Petah Tikva 49372, Israel. atareli@hotmail.com
authors.forename: Eli
authors.initials: E
authors.lastname: Atar
authors.forename: Gil N
authors.initials: GN
authors.lastname: Bachar
authors.forename: Gabriel
authors.initials: G
authors.lastname: Bartal
authors.forename: Eitan
authors.initials: E
authors.lastname: Mor
authors.forename: Haim
authors.initials: H
authors.lastname: Neyman
authors.forename: Franklyn
authors.initials: F
authors.lastname: Graif
authors.forename: Alexander
authors.initials: A
authors.lastname: Belenky
mesh_terms: 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*