Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

Journal Article · Sat Feb 15 04:00:00 EST 2014 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-013-0688-X· OSTI ID:22318112

Pai, Madhava ^[1]; Valek, Vlastimil; Tomas, Andrasina ^[2]; Doros, Attila ^[3]; Quaretti, Pietro ^[4]; Golfieri, Rita; Mosconi, Cristina ^[5]; Habib, Nagy ^[1]

---

1. Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)
2. University Hospital Brno Bohunice, Department of Radiology (Czech Republic)
3. Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary)
4. IRCCS Policlinico San Matteo, Department of Radiology (Italy)
5. University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy)

Purpose: The major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter. Methods: Nine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage. Results: All nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation. Conclusions: In this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

• OSTI ID: 22318112
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 1 Vol. 37; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABLATION
BILE
BILIARY TRACT
CLEARANCE
DEPOSITS
DIGESTIVE SYSTEM DISEASES
DRAINAGE
HEMORRHAGE
JAUNDICE
MAN
METALS
MORTALITY
PANCREAS
PATENTS
PATIENTS
PERFORATION
RADIOWAVE RADIATION