title: Percutaneous use of ePTFE/FEP-covered metallic stent for palliation of malignant biliary obstruction.
abstract: BACKGROUND
  Placement of self-expanding metallic stents has been a standard palliative treatment for patients with inoperable biliary malignancy, aiming at improving quality of life via a minimally invasive procedure. This study aimed to evaluate the efficacy of percutaneous placement of expanded polytetrafluoroethylene/fluorinated ethylene propylene-covered metallic stents for palliation of inoperable biliary malignancy.
  
  
  METHODS
  Between February 2012 and April 2013, 11 patients with inoperable malignant biliary obstruction were treated with stent implantation. Serum bilirubin and liver enzyme levels were measured before/immediately after stent placement and at one, three, and six months. Patient survival and stent patency were calculated using Kaplan-Meier analysis.
  
  
  RESULTS
  No migration occurred. Patients showed clinical improvement immediately and one month after stent placement, with a significant reduction in mean serum bilirubin level (p < 0.05). At six months, bilirubin levels were <1.5 mg/dL in all cases. One patient developed acute liver failure four days after stent implantation, leading to death. Survival rates were 90% at three months and 70% at six months. Primary patency rates were 100%, 100%, and 90% at one, three, and six months, respectively.
  
  
  CONCLUSIONS
  Percutaneous placement of expanded polytetrafluoroethylene/fluorinated ethylene propylene-covered metallic stents offered an effective palliative therapy for patients with inoperable biliary malignancy.
authors.affiliation: Interventional Radiology Department, A.C. Camargo Cancer Center , Sao Paulo, SP , Brazil.
authors.forename: Charles Edouard
authors.initials: CE
authors.lastname: Zurstrassen
authors.forename: Aline Cristine Barbosa
authors.initials: AC
authors.lastname: Santos
authors.forename: Chiang Jeng
authors.initials: CJ
authors.lastname: Tyng
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Matushita
authors.forename: Felipe Jose
authors.initials: FJ
authors.lastname: Coimbra
authors.forename: Alessandro Landskron
authors.initials: AL
authors.lastname: Diniz
authors.forename: Heber Salvador
authors.initials: HS
authors.lastname: Ribeiro
authors.forename: Wilson Luiz
authors.initials: WL
authors.lastname: Costa
authors.forename: Daniel Cunha
authors.initials: DC
authors.lastname: Lima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011138:Polytetrafluoroethylene / Q000031:analogs & derivatives*; D011788:Quality of Life; D015607:Stents; D005465:Fluorocarbon Polymers
chemical_list: D001663:Bilirubin; D011138:Polytetrafluoroethylene; C096305:fluorinated ethylene propylene; D005465:Fluorocarbon Polymers
keywords: Interventional radiology; material science; minimally invasive procedures; self-expanding stent; technology for surgical and interventional radiology