title: Use of a microporous polytetrafluoroethylene catheter balloon to treat refractory esophageal stricture: a novel technique for delivery of mitomycin C.
abstract: OBJECTIVE
  Endoluminal application of mitomycin C shows promise as a nonsurgical approach to treating recalcitrant stricture but requires precise delivery to prevent mitomycin-mediated injury to adjacent normal mucosa. We describe a novel technique that uses a microporous polytetrafluoroethylene catheter balloon to endoluminally deliver mitomycin C to the target tissue while minimizing nontarget drug application.
  
  
  METHODS
  A newborn infant with proximal tracheoesophageal fistula and distal atresia underwent an uncomplicated repair. However, he developed recurrent esophageal stricture resistant to multiple attempts at pneumatic dilations. An image-guided endoluminal radiologic approach that uses microporous polytetrafluoroethylene catheter balloon was developed to precisely deliver mitomycin C to the mucosal lining of the stricture post-dilation.
  
  
  RESULTS
  After uncomplicated pneumatic dilation under fluoroscopic guidance, we used a microporous balloon catheter to endoluminally deliver mitomycin C topically to the mucosa at the level of stricture. Three weeks post procedure, repeat esophagram showed resolution of the stricture with unobstructed flow of contrast material to the stomach. The patient had no observable side effects from mitomycin C application.
  
  
  CONCLUSIONS
  Image-guided therapies based on balloon dilation and drug-eluting microporous balloon techniques offer a safe, precise, and comprehensive approach to the treatment of recalcitrant esophageal strictures.
authors.affiliation: Department of Radiology, BC Children's Hospital, Vancouver, Canada V6H 3V4. Electronic address: mheran@cw.bc.ca.
authors.forename: Manraj K S
authors.initials: MKS
authors.lastname: Heran
authors.affiliation: Division of Pediatric Surgery, Cardon Children's Medical Center, Mesa, AZ, USA.
authors.forename: Tuan H
authors.initials: TH
authors.lastname: Pham
authors.affiliation: Division of Pediatric Surgery, BC Children's Hospital, Vancouver, BC, Canada V6H 3V4.
authors.forename: Sonia
authors.initials: S
authors.lastname: Butterworth
authors.affiliation: Department of Radiology, BC Children's Hospital, Vancouver, Canada V6H 3V4.
authors.forename: Ashley
authors.initials: A
authors.lastname: Robinson
mesh_terms: D000287:Administration, Topical; D000477:Alkylating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D004933:Esophageal Atresia / Q000150:complications / Q000601:surgery; D004940:Esophageal Stenosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage* / Q000627:therapeutic use; D011138:Polytetrafluoroethylene; D011182:Postoperative Care / Q000379:methods
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin; D011138:Polytetrafluoroethylene