Skip to main content
Top
Published in: Digestive Diseases and Sciences 3/2012

01-03-2012 | Original Article

Duodenal and Colonic Stent Placement with 0.025″ and 0.035″ Guidewires Is Equally Safe and Effective

Authors: Jessica Chan, Kristen Hilden, John Fang, Douglas G. Adler

Published in: Digestive Diseases and Sciences | Issue 3/2012

Login to get access

Abstract

Background

The overwhelming majority of reported duodenal and colonic SEMS placements in the literature have used the 0.035″ guidewire almost to the exclusion of guidewires of other diameters.

Aims

The purpose of this study was to compare technical and clinical outcomes in patients undergoing duodenal or colonic SEMS placement with 0.025″ or 0.035″ guidewires.

Methods

This was a retrospective study to compare technical and clinical outcomes and complications of patients receiving duodenal or colonic SEMS placement with a 0.035″ guidewire to those undergoing placement with a 0.025″ guidewire.

Results

A total of 34 duodenal and 30 colonic stent placement procedures were performed in 59 patients. Technical success was achieved in all duodenal stent placement procedures. The difference in mean GOOSS score increase after stent placement was not statistically significant between the 0.035″ and 0.025″ guidewire groups (P = 0.49). Complications were not statistically significantly different between the two groups undergoing gastroduodenal stenting. Technical and clinical success was achieved in all colonic stent placement procedures. There were no statistically significant differences in complication rates between the two groups undergoing colonic stenting. Procedure times were not significantly different using either wire type.

Conclusions

Our study shows that both 0.035″ and 0.025″ guidewires were equally effective with regards to technical success, clinical success, and with regards to the development of complications.
Literature
1.
go back to reference Mauro MA, Koehler RE, Baron TH. Advances in gastrointestinal intervention: the treatment of gastroduodenal and colorectal obstructions with metallic stents. Radiology. 2000;215:659–669.PubMed Mauro MA, Koehler RE, Baron TH. Advances in gastrointestinal intervention: the treatment of gastroduodenal and colorectal obstructions with metallic stents. Radiology. 2000;215:659–669.PubMed
2.
go back to reference Small AJ, Young-Fadok TM, Baron TH. Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases. Surg Endosc. 2008;22:454–462.PubMedCrossRef Small AJ, Young-Fadok TM, Baron TH. Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases. Surg Endosc. 2008;22:454–462.PubMedCrossRef
3.
go back to reference Fregonese D, Naspetti R, Ferrer S, et al. Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction. Gastrointest Endosc. 2008;67:68–73. Fregonese D, Naspetti R, Ferrer S, et al. Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction. Gastrointest Endosc. 2008;67:68–73.
4.
go back to reference Repici A, De Caro G, Luigiano C, et al. WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers. Gastrointest Endosc. 2008;67:77–84.PubMedCrossRef Repici A, De Caro G, Luigiano C, et al. WallFlex colonic stent placement for management of malignant colonic obstruction: a prospective study at two centers. Gastrointest Endosc. 2008;67:77–84.PubMedCrossRef
5.
go back to reference Li YD, Cheng YS, Li MH, et al. Management of acute malignant colorectal obstruction with a novel self-expanding metallic stent as a bridge to surgery. Eur J Radiol. 2010;73:566–571.PubMedCrossRef Li YD, Cheng YS, Li MH, et al. Management of acute malignant colorectal obstruction with a novel self-expanding metallic stent as a bridge to surgery. Eur J Radiol. 2010;73:566–571.PubMedCrossRef
6.
go back to reference Baron TH, Kozarek RA. Endoscopic stenting of colonic tumours. Best Pract Res Clin Gastroenterol. 2004;18:209–229.PubMedCrossRef Baron TH, Kozarek RA. Endoscopic stenting of colonic tumours. Best Pract Res Clin Gastroenterol. 2004;18:209–229.PubMedCrossRef
7.
go back to reference Mutignani M, Tringali A, Shah SG, et al. Combined endoscopic stent insertion in malignant biliary and duodenal obstruction. GI Endosc. 2007;39:440–447.CrossRef Mutignani M, Tringali A, Shah SG, et al. Combined endoscopic stent insertion in malignant biliary and duodenal obstruction. GI Endosc. 2007;39:440–447.CrossRef
8.
go back to reference Yamaguchi Y, Morozumi K, Yamato T, et al. New guide wire technique for stent placement through an occluded self-expandable metal stent: the hairpin technique. J Gastroenterol Hepatol. 2005;20:595–598.PubMedCrossRef Yamaguchi Y, Morozumi K, Yamato T, et al. New guide wire technique for stent placement through an occluded self-expandable metal stent: the hairpin technique. J Gastroenterol Hepatol. 2005;20:595–598.PubMedCrossRef
9.
go back to reference Maetani I, Ukita T, Tada T, Shigoka H, Omuta S, Endo T. Metallic stents for gastric outlet obstruction: reintervention rate is lower with uncovered versus covered stents, despite similar outcomes. Gastrointest Endosc. 2009;69:806–812.PubMedCrossRef Maetani I, Ukita T, Tada T, Shigoka H, Omuta S, Endo T. Metallic stents for gastric outlet obstruction: reintervention rate is lower with uncovered versus covered stents, despite similar outcomes. Gastrointest Endosc. 2009;69:806–812.PubMedCrossRef
10.
go back to reference Kim CG, Choi IJ, Lee JY, et al. Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study. Gastrointest Endosc. 2010;72:25–32.PubMedCrossRef Kim CG, Choi IJ, Lee JY, et al. Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study. Gastrointest Endosc. 2010;72:25–32.PubMedCrossRef
11.
go back to reference Boston Scientific. Wallflex Duodenal Stent Package Insert. 2011;5. Boston Scientific. Wallflex Duodenal Stent Package Insert. 2011;5.
12.
go back to reference Boston Scientific. Wallflex Colonic Stent Package Insert. 2011;5. Boston Scientific. Wallflex Colonic Stent Package Insert. 2011;5.
13.
go back to reference Song GA, Kang DH, Kim TO, et al. Endoscopic stenting in patients with recurrent malignant obstruction after gastric surgery: uncovered versus simultaneously deployed uncovered and covered (double) self-expandable metal stents. Gastrointest Endosc. 2007;65:782–787.PubMedCrossRef Song GA, Kang DH, Kim TO, et al. Endoscopic stenting in patients with recurrent malignant obstruction after gastric surgery: uncovered versus simultaneously deployed uncovered and covered (double) self-expandable metal stents. Gastrointest Endosc. 2007;65:782–787.PubMedCrossRef
14.
go back to reference Kim YW, Choi CW, Kang DH, et al. A double-layered (Comvi) self-expandable metal stent for malignant gastroduodenal obstruction: a prospective multicenter study. Dig Dis Sci. 2011;56:2030–2036.PubMedCrossRef Kim YW, Choi CW, Kang DH, et al. A double-layered (Comvi) self-expandable metal stent for malignant gastroduodenal obstruction: a prospective multicenter study. Dig Dis Sci. 2011;56:2030–2036.PubMedCrossRef
15.
go back to reference Repici A, Adler DG, Gibbs CM, Malesci A, Preatoni P, Baron TH. Stenting of the proximal colon in patients with malignant large bowel obstruction: techniques and outcomes. Gastrointest Endosc. 2007;66:940–944.PubMedCrossRef Repici A, Adler DG, Gibbs CM, Malesci A, Preatoni P, Baron TH. Stenting of the proximal colon in patients with malignant large bowel obstruction: techniques and outcomes. Gastrointest Endosc. 2007;66:940–944.PubMedCrossRef
16.
go back to reference Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97:72–78.PubMedCrossRef Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97:72–78.PubMedCrossRef
17.
go back to reference Small AJ, Coelho-Prabhu N, Baron TH. Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors. Gastrointest Endosc. 2010;71:560–572.PubMedCrossRef Small AJ, Coelho-Prabhu N, Baron TH. Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors. Gastrointest Endosc. 2010;71:560–572.PubMedCrossRef
18.
go back to reference Midgley R, Kerr D. Bevacizumab–current status and future directions. Ann Oncol. 2005;16:999–1004.PubMedCrossRef Midgley R, Kerr D. Bevacizumab–current status and future directions. Ann Oncol. 2005;16:999–1004.PubMedCrossRef
Metadata
Title
Duodenal and Colonic Stent Placement with 0.025″ and 0.035″ Guidewires Is Equally Safe and Effective
Authors
Jessica Chan
Kristen Hilden
John Fang
Douglas G. Adler
Publication date
01-03-2012
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2012
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-011-1932-3

Other articles of this Issue 3/2012

Digestive Diseases and Sciences 3/2012 Go to the issue