Percutaneous use of ePTFE/FEP-covered metallic stent for palliation of malignant biliary obstruction

Minim Invasive Ther Allied Technol. 2014 Dec;23(6):366-73. doi: 10.3109/13645706.2014.939590. Epub 2014 Jul 15.

Abstract

Introduction: 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.

Material and 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.

Conclusion: Percutaneous placement of expanded polytetrafluoroethylene/fluorinated ethylene propylene-covered metallic stents offered an effective palliative therapy for patients with inoperable biliary malignancy.

Keywords: Interventional radiology; material science; minimally invasive procedures; self-expanding stent; technology for surgical and interventional radiology.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / surgery*
  • Bilirubin / blood
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Function Tests
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Polytetrafluoroethylene / analogs & derivatives*
  • Quality of Life
  • Stents*

Substances

  • fluorinated ethylene propylene
  • Polytetrafluoroethylene
  • Bilirubin