title: Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction.
abstract: OBJECTIVE
  We aimed to evaluate the clinical effectiveness and safety of double coaxial self-expandable metallic stent (DCSEMS) in management of malignant colonic obstruction as a bridge to surgery or palliation for inoperable patients.
  
  
  METHODS
  Between April 2006 and December 2012, 49 patients (27 males and 22 females; median age, 68 years; age range, 38-91 years) were selected to receive decompressive therapy for malignant colonic obstruction by implanting a DCSEMS. Application of DCSEMS was attempted in 49 patients under fluoroscopic guidance. The obstruction was located in the transverse colon (n=2), descending colon (n=7), sigmoid colon (n=24), rectosigmoid junction (n=6), and the rectum (n=10). The intended use of DCSEMS was as a bridge to elective surgery in 23 patients and palliation in 26 patients.
  
  
  RESULTS
  Clinical success, defined as >50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 48 of 49 patients (98%). The stent was properly inserted in all patients. No immediate major procedure-related complications occurred. One patient in the bridge-to-surgery group had colon perforation three days after DCSEMS application. Four patients had late migrations of the double stent.
  
  
  CONCLUSIONS
  Application of DCSEMS is safe and effective in management of malignant colonic obstruction; it prevents stent migration and tumor ingrowth and lowers perforation rate during the stent application.
authors.affiliation: Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea,Seoul, Republic of Korea. ymiku@catholic.ac.kr.
authors.forename: Yoodong
authors.initials: Y
authors.lastname: Won
authors.forename: Su Lim
authors.initials: SL
authors.lastname: Lee
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Ku
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kim
authors.forename: Hye Sung
authors.initials: HS
authors.lastname: Won
authors.forename: Chang Hyeok
authors.initials: CH
authors.lastname: An
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications*; D019468:Disease Management; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D016896:Treatment Outcome