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Clinical evaluation of the Haber RAMP TM catheter for endoscopic bilateral metal stent placement in patients with malignant hilar strictures
Author(s) -
Hayashi Kazuki,
Okayama Yasutaka,
Naito Itaru,
Hirai Masaaki,
Kitajima Yasuhiro,
Okamoto Tetsu,
Akita Shinji,
Gotoh Kazuo,
Sano Hitoshi,
Ohara Hirotaka,
Joh Takashi,
Yokoyama Yoshifumi,
Itoh Makoto
Publication year - 2004
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2004.00316.x
Subject(s) - medicine , catheter , stent , surgery , intrahepatic bile ducts , radiology , bile duct
Background:  Endoscopic bilateral expandable metal stent (EMS) placement has been performed in malignant hilar strictures. To perform EMS placement successfully, insertion of guidewires into the bilateral intrahepatic bile ducts is an important and necessary step. In the present study, we evaluated the usefulness of the Haber RAMP TM catheter (HRC) for the selective insertion of guidewires. Methods:  EMS placement was performed in 17 patients with malignant hilar strictures. As the HRC has three lumens connected to apertures facing in different directions, the direction of the guidewire can be controlled at the catheter tip. Insertion of guidewires into bilateral intrahepatic bile ducts was attempted with and without the HRC. Results:  The success rate of guidewire insertion into the bilateral intrahepatic bile ducts was 100% (7/7) when the HRC was used, whereas it was 50% (5/10) without the HRC. In the five patients with insertion failure, reinsertion was successfully performed using the HRC. The time required for the bilateral insertion of guidewires was reduced using the HRC. Bilateral EMSs placement was successful in 14 of the 17 patients (82%). Conclusions:  The HRC was very useful for the accurate and rapid bilateral insertion of guidewires.

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