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Published in: CardioVascular and Interventional Radiology 2/2011

01-04-2011 | Clinical Investigation

Percutaneous Palliation of Pancreatic Head Cancer: Randomized Comparison of ePTFE/FEP–Covered Versus Uncovered Nitinol Biliary Stents

Authors: Miltiadis Krokidis, Fabrizio Fanelli, Gianluigi Orgera, Dimitrios Tsetis, Ioannis Mouzas, Mario Bezzi, Elias Kouroumalis, Roberto Pasariello, Adam Hatzidakis

Published in: CardioVascular and Interventional Radiology | Issue 2/2011

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Abstract

The purpose of this study was to compare the clinical effectiveness of expanded polytetrafluoroethylene/fluorinated-ethylene-propylene (ePTFE/FEP)–covered stents with that of uncovered nitinol stents for the palliation of malignant jaundice caused by inoperable pancreatic head cancer. Eighty patients were enrolled in a prospective randomized study. Bare nitinol stents were used in half of the patients, and ePTFE/FEP–covered stents were used in the remaining patients. Patency, survival, complications, and mean cost were calculated in both groups. Mean patency was 166.0 ± 13.11 days for the bare-stent group and 234.0 ± 20.87 days for the covered-stent group (p = 0.007). Primary patency rates at 3, 6, and 12 months were 77.5, 69.8, and 69.8% for the bare-stent group and 97.5, 92.2, and 87.6% for the covered-stent group, respectively. Mean secondary patency was 123.7 ± 22.5 days for the bare-stent group and 130.3 ± 21.4 days for the covered-stent group. Tumour ingrowth occurred exclusively in the bare-stent group in 27.5% of cases (p = 0.002). Median survival was 203.2 ± 11.8 days for the bare-stent group and 247.0 ± 20 days for the covered-stent group (p = 0.06). Complications and mean cost were similar in both groups. Regarding primary patency and ingrowth rate, ePTFE/FEP–covered stents have shown to be significantly superior to bare nitinol stents for the palliation of malignant jaundice caused by inoperable pancreatic head cancer and pose comparable cost and complications. Use of a covered stent does not significantly influence overall survival rate; nevertheless, the covered endoprosthesis seems to offer result in fewer reinterventions and better quality of patient life.
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Metadata
Title
Percutaneous Palliation of Pancreatic Head Cancer: Randomized Comparison of ePTFE/FEP–Covered Versus Uncovered Nitinol Biliary Stents
Authors
Miltiadis Krokidis
Fabrizio Fanelli
Gianluigi Orgera
Dimitrios Tsetis
Ioannis Mouzas
Mario Bezzi
Elias Kouroumalis
Roberto Pasariello
Adam Hatzidakis
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 2/2011
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-010-9880-4

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