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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
Experimental study in dogs. While pushing a coil catheter through the sheath, the direction is changed from the long axis of the esophagus to the transverse axis oriented toward the pylorus in the stomach. The coil catheter is then advanced to the pylorus with support from the sheath, without any kinking occurring in the stomach.
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Figure 5: Experimental study in dogs. While pushing a coil catheter through the sheath, the direction is changed from the long axis of the esophagus to the transverse axis oriented toward the pylorus in the stomach. The coil catheter is then advanced to the pylorus with support from the sheath, without any kinking occurring in the stomach.

Mentions: Twelve experimental sessions were performed in six mongrel dogs, in order to evaluate the torque and support-ability of the sheath in the stomach, while pushing a guide wire or a coil catheter under fluoroscopic guidance (Fig. 5). For general anesthesia, the dogs were premedicated intramuscularly with ketamine hydrochloride (20 mg/kg, Yuhan Pharmacy, Seoul, Korea) and atropine sulfate (0.5 mg, Daewon Pharmacy, Seoul, Korea). General anesthesia was maintained by an intravenous infusion of ketamine hydrochloride (1-2 mg/kg/min). The dogs were restrained on the fluoroscopic unit (MCA-901 High-End Surgical C-arm, Medison, Seoul, Korea), and a gag was put in their mouth. After the advancement of the 0.038-inch-diameter guide wire into the stomach, a regular sheath coated with lubricating jelly was pushed into the stomach over the guide wire. The sheath was then rotated, so that the tip moved in a direction which was away from the greater curvature of the body and toward the pylorus in the stomach, in order to evaluate the torque and, finally, a wire or coil catheter was pushed toward the pylorus to evaluate the supportability of the sheath. The same experiment was performed again for the supported sheath, with and without a supporting wire in the side lumen.


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)

Experimental study in dogs. While pushing a coil catheter through the sheath, the direction is changed from the long axis of the esophagus to the transverse axis oriented toward the pylorus in the stomach. The coil catheter is then advanced to the pylorus with support from the sheath, without any kinking occurring in the stomach.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Experimental study in dogs. While pushing a coil catheter through the sheath, the direction is changed from the long axis of the esophagus to the transverse axis oriented toward the pylorus in the stomach. The coil catheter is then advanced to the pylorus with support from the sheath, without any kinking occurring in the stomach.
Mentions: Twelve experimental sessions were performed in six mongrel dogs, in order to evaluate the torque and support-ability of the sheath in the stomach, while pushing a guide wire or a coil catheter under fluoroscopic guidance (Fig. 5). For general anesthesia, the dogs were premedicated intramuscularly with ketamine hydrochloride (20 mg/kg, Yuhan Pharmacy, Seoul, Korea) and atropine sulfate (0.5 mg, Daewon Pharmacy, Seoul, Korea). General anesthesia was maintained by an intravenous infusion of ketamine hydrochloride (1-2 mg/kg/min). The dogs were restrained on the fluoroscopic unit (MCA-901 High-End Surgical C-arm, Medison, Seoul, Korea), and a gag was put in their mouth. After the advancement of the 0.038-inch-diameter guide wire into the stomach, a regular sheath coated with lubricating jelly was pushed into the stomach over the guide wire. The sheath was then rotated, so that the tip moved in a direction which was away from the greater curvature of the body and toward the pylorus in the stomach, in order to evaluate the torque and, finally, a wire or coil catheter was pushed toward the pylorus to evaluate the supportability of the sheath. The same experiment was performed again for the supported sheath, with and without a supporting wire in the side lumen.

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