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Newly designed sheaths for gastroduodenal intervention: an experimental study in a phantom and dogs.

Seo TS, Song HY, Lee JH, Ko GY, Sung KB, Lim JO, Ko YH - Korean J Radiol (2004 Apr-Jun)

Bottom Line: The experiments were repeated 30 times, and the results were analyzed using ANOVA with the postHoc test.All three types of sheath rotated smoothly and enabled both the wires and catheters to be guided toward the pylorus of the dog in all cases.The newly designed sheaths can be useful for gastroduodenal intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hysong@www.amc.seoul.kr

ABSTRACT

Objective: To evaluate the usefulness of newly designed sheaths for gastroduodenal intervention in a gastric phantom and dogs.

Materials and methods: A regular sheath was made using a polytetrafluoroethylene tube (4 mm in diameter, 90 cm long) with a bent tip (4 cm long, 100 degree angle). For the supported type of sheath, a 5 Fr catheter was attached to a regular sheath to act as a side lumen. To evaluate their supportability, we measured the distance of movement of the sheath's tip within a silicone gastric phantom for three types of sheath, the regular type, supported type, and supported type with a supporting guide wire. The experiments were repeated 30 times, and the results were analyzed using ANOVA with the postHoc test. In addition, an animal experiment was performed in six mongrel dogs (total: 12 sessions) to evaluate the torque and supportability of the sheaths in the stomach, while pushing a guide wire or coil catheter under fluoroscopic guidance.

Results: In the guide wire application, the distances of movement of the sheath tip in the three types of sheath, the regular type, supported type, and supported type with supporting guide wire, were 8.40+/-0.51 cm, 6.23+/-0.41 cm, and 4.47 +/-0.32 cm, respectively (p < 0.001). In the coil catheter application, the corresponding values were 7.22+/-0.70 cm, 5.61+/-0.31 cm and 3.91+/-0.59 cm, respectively (p < 0.001). All three types of sheath rotated smoothly and enabled both the wires and catheters to be guided toward the pylorus of the dog in all cases.

Conclusion: The newly designed sheaths can be useful for gastroduodenal intervention.

Show MeSH
A regular sheath (left) and supported sheath with a supporting wire in the side lumen (right).
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Figure 1: A regular sheath (left) and supported sheath with a supporting wire in the side lumen (right).

Mentions: Two types of sheaths were designed, namely the regular and supported types (Fig. 1). The regular type of sheath was made of polytetrafluoroethylene (PTFE, Sang-A Flontec Co. Ltd., Incheon, Korea) tube, 90 cm in length with a 4 mm outer diameter and a 3 mm inner diameter. The length of the sheath was decided after consideration of the optimum working length and the distance between the incisor and the esophagogastric junction. The diameter and thickness of the sheath were decided after consideration of the physical properties of the PTFE tube. The distal end of the regular sheath was bent using a heat-gun, creating a bend that was 4 cm long with an angle of curvature of 100 degrees. A radiopaque ring was attached to the outer surface of the distal end of the sheath for the purpose of providing easy detection during fluoroscopic guidance. In order to fabricate the supported sheath, a 5 Fr catheter catheter was attached to a regular sheath to act as the side lumen for the passage of a 0.035-inch wire designed to support the sheath on the other side of the bent tip, parallel to the long axis. The supporting wire in the side lumen can be pushed against the greater curvature of the gastric wall, while supporting the sheath and keeping it oriented toward the pylorus.


Newly designed sheaths for gastroduodenal intervention: an experimental study in a phantom and dogs.

Seo TS, Song HY, Lee JH, Ko GY, Sung KB, Lim JO, Ko YH - Korean J Radiol (2004 Apr-Jun)

A regular sheath (left) and supported sheath with a supporting wire in the side lumen (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698139&req=5

Figure 1: A regular sheath (left) and supported sheath with a supporting wire in the side lumen (right).
Mentions: Two types of sheaths were designed, namely the regular and supported types (Fig. 1). The regular type of sheath was made of polytetrafluoroethylene (PTFE, Sang-A Flontec Co. Ltd., Incheon, Korea) tube, 90 cm in length with a 4 mm outer diameter and a 3 mm inner diameter. The length of the sheath was decided after consideration of the optimum working length and the distance between the incisor and the esophagogastric junction. The diameter and thickness of the sheath were decided after consideration of the physical properties of the PTFE tube. The distal end of the regular sheath was bent using a heat-gun, creating a bend that was 4 cm long with an angle of curvature of 100 degrees. A radiopaque ring was attached to the outer surface of the distal end of the sheath for the purpose of providing easy detection during fluoroscopic guidance. In order to fabricate the supported sheath, a 5 Fr catheter catheter was attached to a regular sheath to act as the side lumen for the passage of a 0.035-inch wire designed to support the sheath on the other side of the bent tip, parallel to the long axis. The supporting wire in the side lumen can be pushed against the greater curvature of the gastric wall, while supporting the sheath and keeping it oriented toward the pylorus.

Bottom Line: The experiments were repeated 30 times, and the results were analyzed using ANOVA with the postHoc test.All three types of sheath rotated smoothly and enabled both the wires and catheters to be guided toward the pylorus of the dog in all cases.The newly designed sheaths can be useful for gastroduodenal intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hysong@www.amc.seoul.kr

ABSTRACT

Objective: To evaluate the usefulness of newly designed sheaths for gastroduodenal intervention in a gastric phantom and dogs.

Materials and methods: A regular sheath was made using a polytetrafluoroethylene tube (4 mm in diameter, 90 cm long) with a bent tip (4 cm long, 100 degree angle). For the supported type of sheath, a 5 Fr catheter was attached to a regular sheath to act as a side lumen. To evaluate their supportability, we measured the distance of movement of the sheath's tip within a silicone gastric phantom for three types of sheath, the regular type, supported type, and supported type with a supporting guide wire. The experiments were repeated 30 times, and the results were analyzed using ANOVA with the postHoc test. In addition, an animal experiment was performed in six mongrel dogs (total: 12 sessions) to evaluate the torque and supportability of the sheaths in the stomach, while pushing a guide wire or coil catheter under fluoroscopic guidance.

Results: In the guide wire application, the distances of movement of the sheath tip in the three types of sheath, the regular type, supported type, and supported type with supporting guide wire, were 8.40+/-0.51 cm, 6.23+/-0.41 cm, and 4.47 +/-0.32 cm, respectively (p < 0.001). In the coil catheter application, the corresponding values were 7.22+/-0.70 cm, 5.61+/-0.31 cm and 3.91+/-0.59 cm, respectively (p < 0.001). All three types of sheath rotated smoothly and enabled both the wires and catheters to be guided toward the pylorus of the dog in all cases.

Conclusion: The newly designed sheaths can be useful for gastroduodenal intervention.

Show MeSH