Image-guided percutaneous gastrostomy using modified large balloon as access target

摘要

Background/Aims: To develop a novel percutaneous radiologic gastrostomy using a large-bore, rupture-free, balloon (RFB) catheter in patients with a swallowing disturbance due to a neurological disorder. Methodology: Consecutive patients underwent percutaneous gastrostomy placement using a balloon catheter with a 5.0-cm x 5.0-cm, large-bore, rupture-free balloon on the tip between August 2010 and December 2011. The large balloon in the stomach was percutaneously punctured by the needle, the guidewire was inserted through the abdominal wall, and the push-type gastrostomy tube was finally inserted over the guidewire via the oral cavity. Technical success and complications were evaluated. Results: Fifteen patients (10 men, 5 women; age range, 47 to 82 years; mean age, 71.7 years) who had cerebral infarction (n=8), intracerebral hemorrhage (n=4), and subarachnoid hemorrhage (n=3) underwent percutaneous radiological gastrostomy. The procedures were technically successful in all patients. The mean procedure time was 34±9 (SD) min (range, 20 to 47min). The average follow-up was 158 days (range, 14 to 655 days). No major complications related to the procedure were encountered. Conclusions: Image-guided gastrostomy using a large-bore RFB catheter is an effective method of gastric feeding in patients with swallowing disturbance due to a neurological disorder.