Usefulness of multifunctional gastrointestinal coil catheter for colorectal stent placement

Abstract

The purpose of this study was to evaluate the usefulness of a multifunctional gastrointestinal coil catheter for stent placement in 98 patients with colorectal strictures. The catheter was used in 98 consecutive patients for stent placement in the rectum (n = 24), recto-sigmoid (n = 13), sigmoid (n = 38), descending (n = 6), transverse (n = 11), splenic flexure (n = 3), hepatic flexure (n = 2), and ascending (n = 1) colon. The catheter was made of a stainless steel coil (1.3 mm in inner diameter), a 0.4-mm nitinol wire, a polyolefin tube, and a hemostasis valve. Usefulness of the catheter was evaluated depending on whether the catheter could pass a stricture over a guide wire and whether measurement of the stricture length was possible. The passage of the catheter over a guide wire beyond the stricture was technically successful and well tolerated in 93 (94.9%) of 98 patients. In the failed five patients, it was not possible to negotiate the guide wire due to presence of nearly complete small bowel obstruction. The average length of stricture was 6.15 cm (range, 3 cm to 20 cm) in patients with the colorectal stricture. There were no procedure-related complications. In conclusion, the multifunctional coil catheter seems to be useful in colorectal stent placement.

The Efficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon

“…Even though fluoroscopy-guided self-expandable metallic stent placement proximal to the descending colon is much more technically difficult than is the endoscopy-guided or combination-guided self-expandable metallic stent placement, many interventional radiologists still implant stents at the obstruction site using fluoroscopic guidance because additional endoscopy guidance can be painful and it is not always feasible. Kim et al (8) introduced a multifunctional gastrointestinal coil catheter to obtain the easy access to the colonic obstruction proximal to the descending colon and to measure the stricture length without removal of the guide wire. Technically successful stent placement was obtained in 93 of 98 patients (95%).…”

“…However, lesions located at or more proximal to the descending colon are more technically challenging because of the tortuous, curved angulations of the sigmoid and descending colon. Furthermore, the angiographic catheter is short (8). Therefore, even if a guide wire can reach the obstructive colonic lesion proximal to the descending colon, the tortuous angulations of the descending colon and the short catheter length may make it difficult for an angiographic catheter to reach a given lesion over a guide wire.…”

Comparison of Clinical Outcomes between Endoscopic and Radiologic Placement of Self-expandable Metal Stent in Patients with Malignant Colorectal Obstruction

“…17,18 In addition, when the obstructive lesion is located at or proximal to the descending colon, the tortuous, curved anatomy of the left colon and the shortness of the catheter make it difficult to even reach the lesion using the radiologic method alone. 19 While various devices, such as the multifunctional gastrointestinal coil catheter, 19 Balkin sheath, 8 and shuttle sheath 20 have been introduced in an attempt to overcome the limitations of placing an angiographic catheter proximal to the descending colon and to prevent the prolapse into the greater curvature of the tortuous, curved sigmoid or descending colon, the limitations of stent insertion using these devices must still be accepted as part of the general procedure because those studies included relatively small numbers of patients and were conducted by interventional radiologists with limited experience. There have even been some reports suggesting that stent placement is more difficult to perform in the descending colon or splenic flexure than in the rectum or sigmoid colon.…”