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ROHAN, Tomáš, Tomáš ANDRAŠINA, Jiří PÁNEK, Jakub HUSTÝ, Vladan BERNARD and Vlastimil VÁLEK. Endoluminal radiofrequency ablation using the monopolar approach for the treatment of an occluded metal biliary stent in malignancy. In CIRSE 2017. 2017. ISSN 0174-1551.

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TY  - CONF
ID  - 1440160
AU  - Rohan, Tomáš - Andrašina, Tomáš - Pánek, Jiří - Hustý, Jakub - Bernard, Vladan - Válek, Vlastimil
PY  - 2017
TI  - Endoluminal radiofrequency ablation using the monopolar approach for the treatment of an occluded metal biliary stent in malignancy
KW  - radiofrequency ablation
KW  - biliary metal stent occlusion
KW  - monopolar approach
N2  - 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.
ER  -

Basic information
Original name	Endoluminal radiofrequency ablation using the monopolar approach for the treatment of an occluded metal biliary stent in malignancy
Authors	ROHAN, Tomáš (203 Czech Republic, belonging to the institution), Tomáš ANDRAŠINA (703 Slovakia, belonging to the institution), Jiří PÁNEK (203 Czech Republic, belonging to the institution), Jakub HUSTÝ (203 Czech Republic, belonging to the institution), Vladan BERNARD (203 Czech Republic, belonging to the institution) and Vlastimil VÁLEK (203 Czech Republic, belonging to the institution).
Edition	CIRSE 2017, 2017.

Other information
Original language	English
Type of outcome	Conference abstract
Field of Study	30224 Radiology, nuclear medicine and medical imaging
Country of publisher	Czech Republic
Confidentiality degree	is not subject to a state or trade secret
Impact factor	Impact factor: 2.210
RIV identification code	RIV/00216224:14110/17:00103764
Organization unit	Faculty of Medicine
ISSN	0174-1551
Keywords in English	radiofrequency ablation; biliary metal stent occlusion; monopolar approach
Tags	International impact
Changed by	Changed by: MUDr. Tomáš Rohan, Ph.D., učo 358905. Changed: 26/1/2019 21:45.

Abstract
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.

Abstract

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.

Links
MUNI/A/1255/2017, interní kód MU	Name: Onkologické radiologické intervence a jejich přínos v rámci komplexní onkologické léčby, srovnání s celorepublikovými výsledky onkologické léčby vybraných diagnóz
MUNI/A/1255/2017, interní kód MU	Investor: Masaryk University, Category A