REGULAR CONTENT
Final ID
634
Type
Educational Exhibit-Poster Only
Authors
P Bream1, R McClure1, J Fleming1, R McClure1
Institutions
1Vanderbilt University Medical Center, Nashville, TN
Purpose
Placement of feeding tubes by Interventional Radiologists (IR) is an effective and safe procedure. Traditionally, small bore pigtail tubes were placed and then later upsized. Specially designed, larger peel-away sheaths now allow large bore gastrostomy tube placement de novo. We describe our experience with a procedure that avoids dilators by utilizing a standard angioplasty balloon placed coaxially within the tube to provide one step dilatation and advancement into the stomach.
Materials & Methods
After institutional IRB approval, the medical records of 50 consecutive patients were reviewed. Of these patients, 12 had ALS, 32 had head/neck cancer, 1 had gastroparesis, and 15 had another underlying diagnosis. The mean age was 61.93 years (SD 12.21). Sedation time, fluoroscopy time, radiation dose, and short and long term complications were recorded.
Results
Out of 50 procedures, 48 were technically successful; 2 could not be completed due to lack of a percutaneous gastric window. 45 procedures were done with moderate sedation while 3 were completed with local bupivacaine only. At the time of writing, 70.8% of tubes remained in the patient, 25% were removed for completion of therapy, and 4.2% were removed due to patient death. None were removed for complication.
Conclusions
The BAG is an alternative push method for placing de novo 20 French gastrostomy tubes without the pain and inconvenience of multiple dilators. The procedure is well tolerated with minimal or no sedation, making it ideal for patients with neurologic dysfunction (ALS) or head and neck cancers with obstructing tumors.
Final ID
634
Type
Educational Exhibit-Poster Only
Authors
P Bream1, R McClure1, J Fleming1, R McClure1
Institutions
1Vanderbilt University Medical Center, Nashville, TN
Purpose
Placement of feeding tubes by Interventional Radiologists (IR) is an effective and safe procedure. Traditionally, small bore pigtail tubes were placed and then later upsized. Specially designed, larger peel-away sheaths now allow large bore gastrostomy tube placement de novo. We describe our experience with a procedure that avoids dilators by utilizing a standard angioplasty balloon placed coaxially within the tube to provide one step dilatation and advancement into the stomach.
Materials & Methods
After institutional IRB approval, the medical records of 50 consecutive patients were reviewed. Of these patients, 12 had ALS, 32 had head/neck cancer, 1 had gastroparesis, and 15 had another underlying diagnosis. The mean age was 61.93 years (SD 12.21). Sedation time, fluoroscopy time, radiation dose, and short and long term complications were recorded.
Results
Out of 50 procedures, 48 were technically successful; 2 could not be completed due to lack of a percutaneous gastric window. 45 procedures were done with moderate sedation while 3 were completed with local bupivacaine only. At the time of writing, 70.8% of tubes remained in the patient, 25% were removed for completion of therapy, and 4.2% were removed due to patient death. None were removed for complication.
Conclusions
The BAG is an alternative push method for placing de novo 20 French gastrostomy tubes without the pain and inconvenience of multiple dilators. The procedure is well tolerated with minimal or no sedation, making it ideal for patients with neurologic dysfunction (ALS) or head and neck cancers with obstructing tumors.