Usefulness of a guiding sheath for fluoroscopic stent placement in patients with malignant gastroduodenal obstruction.

BackgroundSelf-expandable metallic stent placement is widely used to manage malignant gastroduodenal obstructions. However, there are difficulties in negotiating a guidewire (GW) and a stent delivery system (SDS).PurposeTo investigate feasibility, usefulness, and safety of a guiding sheath for fluoroscopic stent placement in patients with malignant gastroduodenal obstructions.Material and MethodsIn July 2001 to August 2011, 726 patients with malignant gastroduodenal obstructions underwent stent placement. Guiding sheath was used in patients in whom a GW could not be passed through the obstruction and a SDS failed to reach the obstruction. Sheath usefulness was evaluated based on the ability of the sheath to successfully assist. The technical success rate and the most frequent reasons for the use of a sheath were evaluated.ResultsThe guiding sheath was needed in 148 of 726 patients (20%). The overall technical success rate was 98% with the guiding sheath. In two of 148 patients, stent placement failed beca...