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Endoluminal radiofrequency ablation using the monopolar approach for the treatment of an occluded metal biliary stent in malignancy

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ROHAN Tomáš ANDRAŠINA Tomáš PÁNEK Jiří HUSTÝ Jakub BERNARD Vladan VÁLEK Vlastimil

Rok publikování 2017
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Popis Purpose To prove the efficacy and safety of endoluminal radiofrequency ablation using the monopolar approach for the treatment of an occluded metal biliary stent in malignancy. Material and methods The study includes 11 patients with metal biliary stents implanted for treating malignant biliary obstruction. All patients were selected according to our hospital's indication criteria for occluded metal biliary stent recanalisation. The stent recanalisation was performed under fluoroscopic control with radiofrequency ablation catheter EndoHPB 8F connected to the generator 1500X RF using a monopolar approach. The effect of radiofrequency ablation in the treatment of occluded metal biliary stents was evaluated by biliary tract fluoroscopy. Enrolled patients were prospectively followed-up. Results In all 11 cases, radiofrequency ablation using the monopolar approach was successful for stent recanalisation. The average period of stent patency before recanalisation was 6.9 months (3–12, median 5.5 months) and stent patency after recanalisation was an additional 4.8 months (1.5–12, median 5 months). Eight of 11 patients died during the follow-up within an average of 15 months (9.5–25, median 12 months) after stent placement, respectively, in 15.3 months (Kaplan–Meier analysis). No complications were observed during and after the procedure. Three patients are still alive; two of them surviving for 10 months and one surviving for 25 months after stent placement. Conclusion The monopolar approach for using the endoluminal radiofrequency catheter for occluded metal biliary stent recanalisation seems to be a precise and efficient technique for treating tissue ingrowth. However, the natural course of oncological disease and disadvantages of the catheter-based technique for recanalisation may lead to early procedural failure.
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