title: Large or small bore, push or pull: a comparison of three classes of percutaneous fluoroscopic gastrostomy catheters.
abstract: OBJECTIVE
  To compare the tube performance and complication rates of small-bore, large-bore push-type, and large-bore pull-type gastrostomy catheters.
  
  
  METHODS
  A total of 160 patients (74 men, 86 women; mean age, 66.9 years, range, 22-95 y) underwent percutaneous fluoroscopic gastrostomy placement between January 2004 and March 2006. Choice of catheter was based on the preference of the attending radiologist. Data were collected retrospectively with institutional review board approval. Radiology reports provided information on the catheter, indication for gastrostomy, technical success, and immediate outcome. Chart review provided data on medical history, postprocedural complications, progress to feeding goal, and clinical outcomes. Statistical analysis was performed to compare the three classes of gastrostomy catheters.
  
  
  RESULTS
  All 160 catheters were placed successfully. Patients who received small-bore catheters (14 F; n = 88) had significantly more tube complications (17% vs 5.6%) and were less likely to meet their feeding goal (P = .035) compared with patients with large-bore catheters (20 F; n = 72). No difference was observed in terms of major or minor complications. Large-bore push-type (n = 14) and pull-type catheters (n = 58) were similar in terms of complication rates. Patients who received large-bore push-type catheters achieved their feeding goals in significantly less time than those with large-bore pull-type catheters (average, 3.8 days vs 6.0 days; P = .04).
  
  
  CONCLUSIONS
  Patients who received small-bore gastrostomy catheters are significantly more prone to tube dysfunction. Large-bore catheters should be preferentially used, with push-type catheters performing better with regard to the time to achieve feeding goal.
authors: Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors: Yuo-Chen
authors: YC
authors: Kuo
authors: Richard D
authors: RD
authors: Shlansky-Goldberg
authors: Jeffrey I
authors: JI
authors: Mondschein
authors: S William
authors: SW
authors: Stavropoulos
authors: Aalpen A
authors: AA
authors: Patel
authors: Jeffrey A
authors: JA
authors: Solomon
authors: Michael C
authors: MC
authors: Soulen
authors: Andrew
authors: A
authors: Kwak
authors: Maxim
authors: M
authors: Itkin
authors: Jesse L
authors: JL
authors: Chittams
authors: Scott O
authors: SO
authors: Trerotola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D005260:Female; D005471:Fluoroscopy; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies