title: The efficacy of the coaxial technique using a 6-Fr introducer sheath in stent placement for treating the obstructions proximal to the descending colon.
abstract: OBJECTIVE
  We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon.
  
  
  METHODS
  Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed.
  
  
  RESULTS
  Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4; mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients.
  
  
  CONCLUSIONS
  The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon.
authors.affiliation: Department of Radiology, Konkuk University Hospital, Seoul 143-729, Korea.
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Chang
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Dae-Yong
authors.initials: DY
authors.lastname: Hwang
authors.forename: Moo Kyung
authors.initials: MK
authors.lastname: Seong
authors.forename: Hee-Kyung
authors.initials: HK
authors.lastname: Joh
authors.forename: So Young
authors.initials: SY
authors.lastname: Yoon
authors.forename: Yo-Han
authors.initials: YH
authors.lastname: Cho
authors.forename: Won Hyeok
authors.initials: WH
authors.lastname: Choe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057785:Catheters; D044683:Colon, Descending; D003108:Colonic Diseases / Q000209:etiology / Q000628:therapy*; D003110:Colonic Neoplasms / Q000150:complications; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents