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(Radiology. 2000;214:358-362.)
© RSNA, 2000

Vascular and Interventional Radiology

Percutaneous Incision of Stenotic Uroenteric Anastomoses with a Cutting Balloon Catheter: Long-term Results1

François Cornud, MD, Yves Chrétien, MD, Olivier Hélénon, MD, Jean-Michel Casanova, MD, Jean-Michel Correas, MD, PhD, Didier Bonnel, MD, Arnaud Méjean, MD and Jean-François Moreau, MD

1 From the Departments of Radiology (F.C., O.H., J.M. Correas, J.M. Casanova, D.B., J.F.M.) and Urology (Y.C., A.M.), Hôpital Necker, Paris, France; and Collège Européen et Francophone d'Urologie Libérale, Paris (F.C., J.M. Casanova, D.B.). Received October 13, 1998; revision requested December 8; final revision received April 16, 1999; accepted July 27. Address reprint requests to F.C., 15 Avenue Robert Schuman, 75007 Paris, France (e-mail: frcornud@club-internet.fr).

PURPOSE: To describe the technique and results of incision of strictures in anastomotic urinary diversions with a commercially available cutting balloon catheter.

MATERIALS AND METHODS: Thirty-seven stenoses were treated in 32 patients. Most (28 [88%]) of the patients had undergone surgery for bladder cancer 17.7 months ± 17.4 (SD) (range, 3–72 months) before incision. Thirteen patients had undergone ileal conduit diversion, and nineteen had undergone enterocystoplasty. All stenoses were shorter than 3 cm. The presence of adjacent ileal loops and/or iliac vessels was assessed with computed tomography before incision. The cutting wire was oriented anteriorly or anterolaterally, and the balloon was inflated with diluted contrast material during the incision. A Kaplan-Meier survival curve was constructed to illustrate the success rates over time.

RESULTS: No major complications occurred. Twelve (32%) stenoses recurred in nine patients 15 months ± 10 (range, 6–36 months) after stent removal; the failure rate was 53% (eight of 15 stenoses) for ileal conduits and 18% (four of 22 stenoses) for enterocystoplasties. Late failure (>12 months) was observed in four patients. The patency of the other 25 stenoses (23 patients) was checked 25 months ± 11 after stent removal (range, 5–43 months). The actuarial patency rate was 77% at 1 year, 68% at 2 years, and 62% at 3 years.

CONCLUSION: Cutting balloon incision is a safe and simple alternative to surgery, particularly when the urinary diversion is enterocystoplasty.

Index terms: Bladder, interventional procedures, 83.1267 • Bladder, neoplasms, 83.32 • Ureter, interventional procedures, 82.1267 • Ureter, stenosis or obstruction, 82.842, 82.843






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