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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

Related in: MedlinePlus

A. An outline of the stomach was drawn, in order to make the gastric phantom, as follows. The distances from the greater to lesser curvature were measured in each section on the abdominal CT scan. The locations of the greater curvature on one section relative to that on the next section on the abdominal CT scan were also evaluated. Both the distances and relative locations were plotted on a 2-dimensional plane; subsequently, the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane. The esophageal outline was drawn from the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm.B. Clay was shaped, so as to be 2 cm in height, and to follow the gastric contour with a tubular shape at the esophageal portion.
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Figure 2: A. An outline of the stomach was drawn, in order to make the gastric phantom, as follows. The distances from the greater to lesser curvature were measured in each section on the abdominal CT scan. The locations of the greater curvature on one section relative to that on the next section on the abdominal CT scan were also evaluated. Both the distances and relative locations were plotted on a 2-dimensional plane; subsequently, the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane. The esophageal outline was drawn from the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm.B. Clay was shaped, so as to be 2 cm in height, and to follow the gastric contour with a tubular shape at the esophageal portion.

Mentions: To draw the outline of the stomach, the distance from the greater curvature of the stomach to the lesser curvature was measured on each section of an abdominal CT (Somatom Plus IV, Siemens, Erlangen, Germany) scan taken after the ingestion of one liter of contrast media (slice thickness = 1 cm) in a patient in whom the gastric outlet was not obstructed. The distances from the location of the greater curvature on one section of the CT scan to the same location on the lower and upper sections were also measured. Both the distances from the greater to the lesser curvature and the location of the greater curvature on one section relative to that on the next section were plotted on a 2-dimensional plane, and the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane (Fig. 2A). The esophageal outline was drawn from the distal portion of the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm. Clay was shaped so as to have a thickness of 2 cm, in order to produce the gastric contour with a tubular shape at the esophageal portion, and it was then put into a molding flask made of acryl plate (Atoglas, Elf Atochem Korea Ltd., Seoul, Korea) (Fig. 2B). The molding flask was then filled with silicone, and the hardening process was performed. The clay in the gastric and esophageal portion was removed from the hardened silicone, and the exposed side of the silicone was covered with a lucent acryl plate. The cavity between the acryl plate and the hardened silicone having the shape of a stomach was used as the gastric phantom. PTFE tube, with an outer diameter of 3 mm and a length of 10 cm, having a blind distal end, was attached to the gastric phantom, so as to act as the duodenal and pyloric portions of the stomach.


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. An outline of the stomach was drawn, in order to make the gastric phantom, as follows. The distances from the greater to lesser curvature were measured in each section on the abdominal CT scan. The locations of the greater curvature on one section relative to that on the next section on the abdominal CT scan were also evaluated. Both the distances and relative locations were plotted on a 2-dimensional plane; subsequently, the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane. The esophageal outline was drawn from the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm.B. Clay was shaped, so as to be 2 cm in height, and to follow the gastric contour with a tubular shape at the esophageal portion.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: A. An outline of the stomach was drawn, in order to make the gastric phantom, as follows. The distances from the greater to lesser curvature were measured in each section on the abdominal CT scan. The locations of the greater curvature on one section relative to that on the next section on the abdominal CT scan were also evaluated. Both the distances and relative locations were plotted on a 2-dimensional plane; subsequently, the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane. The esophageal outline was drawn from the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm.B. Clay was shaped, so as to be 2 cm in height, and to follow the gastric contour with a tubular shape at the esophageal portion.
Mentions: To draw the outline of the stomach, the distance from the greater curvature of the stomach to the lesser curvature was measured on each section of an abdominal CT (Somatom Plus IV, Siemens, Erlangen, Germany) scan taken after the ingestion of one liter of contrast media (slice thickness = 1 cm) in a patient in whom the gastric outlet was not obstructed. The distances from the location of the greater curvature on one section of the CT scan to the same location on the lower and upper sections were also measured. Both the distances from the greater to the lesser curvature and the location of the greater curvature on one section relative to that on the next section were plotted on a 2-dimensional plane, and the contour of the greater and lesser curvature of the stomach was drawn by connecting these points on a 2-dimensional plane (Fig. 2A). The esophageal outline was drawn from the distal portion of the esophagus to the cardia, with a diameter of 2 cm and a length of 5 cm. Clay was shaped so as to have a thickness of 2 cm, in order to produce the gastric contour with a tubular shape at the esophageal portion, and it was then put into a molding flask made of acryl plate (Atoglas, Elf Atochem Korea Ltd., Seoul, Korea) (Fig. 2B). The molding flask was then filled with silicone, and the hardening process was performed. The clay in the gastric and esophageal portion was removed from the hardened silicone, and the exposed side of the silicone was covered with a lucent acryl plate. The cavity between the acryl plate and the hardened silicone having the shape of a stomach was used as the gastric phantom. PTFE tube, with an outer diameter of 3 mm and a length of 10 cm, having a blind distal end, was attached to the gastric phantom, so as to act as the duodenal and pyloric portions of the stomach.

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
Related in: MedlinePlus