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

Journal Article · Fri Apr 15 00:00:00 EDT 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9880-4· OSTI ID:21608724

Krokidis, Miltiadis ^[1]; Fanelli, Fabrizio ^[2]; Orgera, Gianluigi ^[3]; Tsetis, Dimitrios ^[4]; Mouzas, Ioannis ^[5]; Bezzi, Mario ^[2]; Kouroumalis, Elias ^[5]; Pasariello, Roberto ^[2]; Hatzidakis, Adam ^[6]

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1. Guy's and St. Thomas' Hospitals, Department of Radiology (United Kingdom)
2. 'La Sapienza' University of Rome, Department of Radiological Sciences (Italy)
3. European Institute of Oncology, Unit of Interventional Radiology (Italy)
4. University Hospital of Heraklion, Medical School of Crete, Department of Radiology (Greece)
5. University Hospital of Heraklion, Medical School of Crete, Department of Gastroenterology (Greece)
6. Medical School of Crete (Greece)

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.

• OSTI ID: 21608724
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 34, Issue 2; Other Information: DOI: 10.1007/s00270-010-9880-4; Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ETHYLENE
HEAD
JAUNDICE
NEOPLASMS
NICKEL ALLOYS
PANCREAS
PATIENTS
POLYTETRAFLUOROETHYLENE
PROPYLENE
TITANIUM ALLOYS
ALKENES
ALLOYS
BODY
DIGESTIVE SYSTEM
DISEASES
ENDOCRINE GLANDS
FLUORINATED ALIPHATIC HYDROCARBONS
GLANDS
HALOGENATED ALIPHATIC HYDROCARBONS
HYDROCARBONS
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC POLYMERS
ORGANS
PATHOLOGICAL CHANGES
POLYETHYLENES
POLYMERS
POLYOLEFINS
SYMPTOMS
TRANSITION ELEMENT ALLOYS