title: Radiologically Guided Placement of Mushroom-retained Gastrostomy Catheters: Long-term Outcomes of Use in 300 Patients at a Single Center.
abstract: OBJECTIVE
  To assess long-term outcomes including risk of complications and nutritional benefits of mushroom-retained (pull-type) gastrostomy catheters placed in patients by interventional radiologists.
  
  
  METHODS
  All patients who received pull-type gastrostomy tubes between 2010 and 2013 were retrospectively reviewed, including 142 men (average weight, 169.6 lb [76.32 kg]; mean age, 65.2 years; range, 22-92 years) and 158 women (average weight, 150.4 lb [67.68 kg]; mean age, 65.2 years; range, 18-98 years). Indications for placement were cerebrovascular accident (n = 80), failure to thrive (n = 71), other central nervous system disorder (n = 51), head and neck cancer (n = 47), and other malignancy (n = 51). Complications were recorded per Society of Interventional Radiology practice guidelines. Patient weight was documented at specific follow-up intervals. Statistical analysis was performed by using the Student t test and one-way analysis of variance for the effects of sex and indication for placement, respectively, on average weight change.
  
  
  RESULTS
  The technical success rate was 98.4% (300 of 305 patients). Major and minor complications occurred at a rate of 3.7% (n = 11) and 13% (n = 39), respectively. Follow-up weight during the early (≤45 days), intermediate (≤180 days), and long-term (>180 days) periods was available for 71% (n = 214), 36% (n = 108), and 15% (n = 44) of the 300 patients, respectively. Weight gain occurred in 77% (160 of 214), 60% (65 of 108), and 73% (32 of 44) of the patients, respectively. Patients who gained weight gained 6.7, 10.6, and 16.3 lb (3.02, 4.77, and 7.34 kg) during each follow-up period, respectively. Average weight gain at follow-up in all patients was 4.2, 0.6, and 5.4 lb (1.89, 0.27, and 2.43 kg), respectively. No significant differences in average weight change were seen among groups when they were classified according to sex or indication for placement.
  
  
  CONCLUSIONS
  Placement of mushroom-retained gastrostomy catheters is a viable long-term treatment option for enteral nutrition, with complication rates similar to those reported for other gastrostomy techniques. Improvement in nutrition status measured as weight gain was seen in most patients in both early and long-term periods.
authors.affiliation: From the Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (O.A., S.S., M.G., B.F.); and Wright State University Boonshoft School of Medicine, Dayton, Ohio (D.J.).
authors.forename: Osman
authors.initials: O
authors.lastname: Ahmed
authors.affiliation: From the Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (O.A., S.S., M.G., B.F.); and Wright State University Boonshoft School of Medicine, Dayton, Ohio (D.J.).
authors.forename: Danial
authors.initials: D
authors.lastname: Jilani
authors.affiliation: From the Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (O.A., S.S., M.G., B.F.); and Wright State University Boonshoft School of Medicine, Dayton, Ohio (D.J.).
authors.forename: Sujay
authors.initials: S
authors.lastname: Sheth
authors.affiliation: From the Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (O.A., S.S., M.G., B.F.); and Wright State University Boonshoft School of Medicine, Dayton, Ohio (D.J.).
authors.forename: Maryellen
authors.initials: M
authors.lastname: Giger
authors.affiliation: From the Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (O.A., S.S., M.G., B.F.); and Wright State University Boonshoft School of Medicine, Dayton, Ohio (D.J.).
authors.forename: Brian
authors.initials: B
authors.lastname: Funaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods*; D057785:Catheters; D004867:Equipment Design; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult