Usefulness of a long sheath in ureteral catheterization after failure of antegrade ureteral stent placement using a short sheath.
| Autor: | Chen CS; Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China., Kim JW; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Shin JH; Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China.; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Li HL; Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, PR China., Lee HJ; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Ibrahim A; Department of Radiology, Prince Sultan Military Medical City, Riyadh. Saudi Arabia., Jang EB; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. |
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| Jazyk: | angličtina |
| Zdroj: | Acta radiologica (Stockholm, Sweden : 1987) [Acta Radiol] 2021 Dec; Vol. 62 (12), pp. 1674-1678. Date of Electronic Publication: 2020 Oct 29. |
| DOI: | 10.1177/0284185120969952 |
| Abstrakt: | Background: When antegrade ureteral intervention fails due to severe ureteral stricture or tortuosity, a longer sheath can be used to facilitate ureteral catheterization. Purpose: To evaluate the feasibility and effectiveness of the use of a long sheath in antegrade ureteral stent placement after failure of antegrade ureteral stent placement using a short sheath. Material and Methods: Among 1284 procedures in 934 patients who received ureteral stent placement, a long sheath was used after stricture negotiation failure using a short sheath in 57 (4.4%) procedures in 53 patients. The data of these 53 patients were retrospectively reviewed. Results: The most common reasons for long sheath use were failure of balloon catheter (59.6%) or guidewire (29.8%) advancement across the stricture. Technical success, successful stricture negotiation after using a long sheath, was achieved in 50/57 (87.7%) procedures. In two of seven failed procedures, an additional TIPS sheath was used and the technical success rate improved to 91.2% (52/57). The technical success rate was significantly higher in the patients who have failed balloon catheter advancement (97.1%, 33/34) than the patients who have failed guidewire advancement (64.7%, 11/17) (Fisher's exact test, P = 0.004). Self-limiting hematoma occurred in one patient after use of the long sheath and was considered a minor complication. Conclusion: Ureteral catheterization using a long sheath is feasible and effective when antegrade ureteral intervention using a short sheath fails. When using a long sheath, the technical success rate was higher when advancing the balloon catheter over the guidewire than when advancing the guidewire through tight stricture. |
| Databáze: | MEDLINE |
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