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Three year results with a novel bariatric device
S42
’
Sunday
Scientific Session
3
SUNDAY: Scientific Sessions
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 4Asan Medical Hospital, Seoul, Seoul; 5Asan Medical Center, Seoul-City, Republic of Korea; 6University of Ulsan College of Medicine, Seoul, Korea Purpose: To compare the outcomes of fluoroscopic stent placement (FSP) and endoscopic stent placement (ESP) in patients with malignant gastric outlet obstruction (GOO). Materials: A retrospective study was performed in 306 patients who were treated either by FSP (n ¼ 125) or ESP (n ¼ 181). The outcomes were assessed the following variables: success rates; procedure time; complications; re-intervention; stent patency; and survival. Results: A total of 193 patients met our inclusion criteria, including 125 patients in FSP and 68 patients in ESP. The technical and clinical outcomes did not differ between the two groups. The stent migration was higher in the ESP group than in the FSP group (P ¼ 0.002). In the ESP group, the use of the straight end of the stent and chemotherapy were associated with an increase in stent migration. The stent collapse was lower in the ESP group than in the FSP group (P ¼ 0.021). The six-month stent patency was higher in the ESP group than in the FSP group (P ¼ 0.044). Conclusions: Despite the significant difference in the stent migration and collapse rates, the technical and clinical outcomes were similar between the two groups for the palliation of malignant GOO.
3:00 PM
Abstract No. 84
Incidence and outcomes of major bleeding complications following transjugular liver biopsy: a single center review of 1600 cases D. Biederman1, B. Marinelli2, J. Titano2, N. Tabori1, E. Kim3, R. Patel3, F. Nowakowski1, R. Lookstein4, A. Fischman2; 1N/A, New York, NY; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Mount Sinai Medical Center, New York, NY; 4Mount Sinai Hospital, New York, NY Purpose: Transjuglar liver biopsy (TJLB) is an alternative to percutaneous liver biopsy commonly used in hypocoaguable patients. In this study we evaluated the incidence and outcomes of major bleeding complications secondary to TJLB. Materials: A single center retrospective review of all TJLBs was performed. Patients with a transhepatic portosystemic shunt (TIPS) placed at the time of TJLB were excluded. Complications were defined according to the Society of Interventional Radiology criteria. Major bleeding complications were identified by reviewing all cross sectional (CT and MR) exams performed within 10 days after TJLB. The primary outcome variable was development of a major bleeding complication. Secondary outcome variables included need for secondary intervention, and procedure related mortality. Results: From 1/2002 to 12/2014 a total of 1613 consecutive TJLB were performed. Of these total, 1576 procedures met the study inclusion criteria. A total of 157 cross-sectional imaging studies in the 10-day post procedural period were reviewed. Seven major bleeding complications (0.4 %) were identified, including
’
JVIR
intraperitoneal hemorrhage (n ¼ 5) and large hematoma (n ¼ 2). Active extravasation was identified in 3 cases, all of which required re-intervention. There were 3 (0.2 %) procedure related mortalities. Active bleeding at the time of follow-up imaging (p ¼ 0.061) was associated with a trend towards increased mortality risk. Conclusions: Major bleeding complications post-TJLB are very rare but associated with a significant mortality risk.
3:45 PM
Abstract No. 85
Three year results with a novel bariatric device S. Solomon1, E. Noren2, H. Forssell2; 1New York, NY; 2 Blekinge County Hospital, Blekinge, Karlskrona Purpose: Obesity is a major public health problem with few effective treatment options. The purpose of this prospective study was to evaluate weight loss efficacy and safety of a new device for treating obesity, the AspireAssist® Aspiration Therapy System (Aspire Bariatrics, King of Prussia, PA). Materials: From July 2012 through September 2012, 25 obese subjects with a mean BMI of 39.8 þ 4.3 kg/m2 were enrolled in a pilot study. This was an Ethics Committee approved, single center study performed at Blekinge County Hospital, Karlskrona, Sweden. The AspireAssist® Aspiration Therapy System (AspireAssist) comprises a percutaneous gastrostomy tube (Atube) through which patients aspirate a portion of ingested meals from the stomach and an accessory siphon device that facilitates aspiration. The study was planned as a one year study, but 12 subjects wished to keep their device for up to 3 years. Results: Of 25 subjects, 22 subjects completed one year, 15 subjects 2 years, and 12 subjects completed 3 years. The mean weight loss for the 12 patients who completed 3 years was 26 kg with an excess weight loss (EWL) of mean 58%. On an Intent to treat basis, using last observation carry-forward, mean weight loss at the end of year 1,2, 3 was 48% (19 kg), 46% (18 kg), and 45% EWL (19 kg), respectively. Conclusions: The AspireAssist Aspiration Therapy System enables a low risk, reversible weight loss therapy with results approaching that of bariatric surgery.
4:03 PM
Abstract No. 86
Retrospective Review of percutaneous radiologic gastrostomy placement in patients with amyotrophic lateral sclerosis R. Fricke1, R. Pahls2, R. Li3, J. Meek3; 1University of Arkansas for Medical Sciences, Little Rock, AR; 2UAMS, Little Rock, AR; 3N/A, Little Rock, AR Purpose: Gastrostomy placement is indicated in ALS patients with malnutrition and weight loss, as these have been shown to be negative prognostic indicators (1). Radiologic gastrostomy placement carries the benefit of not requiring intubation and ventilator support necessary in endoscopic techniques. The purpose of this study is to retrospectively evaluate complication rate of percutaneous radiologic gastrostomy placement in patients with ALS. Materials: Twenty five patients (12 men and 13 women; mean age 66) with ALS received PRG placement between
’
Sunday
Scientific Session
3
SUNDAY: Scientific Sessions
Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 4Asan Medical Hospital, Seoul, Seoul; 5Asan Medical Center, Seoul-City, Republic of Korea; 6University of Ulsan College of Medicine, Seoul, Korea Purpose: To compare the outcomes of fluoroscopic stent placement (FSP) and endoscopic stent placement (ESP) in patients with malignant gastric outlet obstruction (GOO). Materials: A retrospective study was performed in 306 patients who were treated either by FSP (n ¼ 125) or ESP (n ¼ 181). The outcomes were assessed the following variables: success rates; procedure time; complications; re-intervention; stent patency; and survival. Results: A total of 193 patients met our inclusion criteria, including 125 patients in FSP and 68 patients in ESP. The technical and clinical outcomes did not differ between the two groups. The stent migration was higher in the ESP group than in the FSP group (P ¼ 0.002). In the ESP group, the use of the straight end of the stent and chemotherapy were associated with an increase in stent migration. The stent collapse was lower in the ESP group than in the FSP group (P ¼ 0.021). The six-month stent patency was higher in the ESP group than in the FSP group (P ¼ 0.044). Conclusions: Despite the significant difference in the stent migration and collapse rates, the technical and clinical outcomes were similar between the two groups for the palliation of malignant GOO.
3:00 PM
Abstract No. 84
Incidence and outcomes of major bleeding complications following transjugular liver biopsy: a single center review of 1600 cases D. Biederman1, B. Marinelli2, J. Titano2, N. Tabori1, E. Kim3, R. Patel3, F. Nowakowski1, R. Lookstein4, A. Fischman2; 1N/A, New York, NY; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Mount Sinai Medical Center, New York, NY; 4Mount Sinai Hospital, New York, NY Purpose: Transjuglar liver biopsy (TJLB) is an alternative to percutaneous liver biopsy commonly used in hypocoaguable patients. In this study we evaluated the incidence and outcomes of major bleeding complications secondary to TJLB. Materials: A single center retrospective review of all TJLBs was performed. Patients with a transhepatic portosystemic shunt (TIPS) placed at the time of TJLB were excluded. Complications were defined according to the Society of Interventional Radiology criteria. Major bleeding complications were identified by reviewing all cross sectional (CT and MR) exams performed within 10 days after TJLB. The primary outcome variable was development of a major bleeding complication. Secondary outcome variables included need for secondary intervention, and procedure related mortality. Results: From 1/2002 to 12/2014 a total of 1613 consecutive TJLB were performed. Of these total, 1576 procedures met the study inclusion criteria. A total of 157 cross-sectional imaging studies in the 10-day post procedural period were reviewed. Seven major bleeding complications (0.4 %) were identified, including
’
JVIR
intraperitoneal hemorrhage (n ¼ 5) and large hematoma (n ¼ 2). Active extravasation was identified in 3 cases, all of which required re-intervention. There were 3 (0.2 %) procedure related mortalities. Active bleeding at the time of follow-up imaging (p ¼ 0.061) was associated with a trend towards increased mortality risk. Conclusions: Major bleeding complications post-TJLB are very rare but associated with a significant mortality risk.
3:45 PM
Abstract No. 85
Three year results with a novel bariatric device S. Solomon1, E. Noren2, H. Forssell2; 1New York, NY; 2 Blekinge County Hospital, Blekinge, Karlskrona Purpose: Obesity is a major public health problem with few effective treatment options. The purpose of this prospective study was to evaluate weight loss efficacy and safety of a new device for treating obesity, the AspireAssist® Aspiration Therapy System (Aspire Bariatrics, King of Prussia, PA). Materials: From July 2012 through September 2012, 25 obese subjects with a mean BMI of 39.8 þ 4.3 kg/m2 were enrolled in a pilot study. This was an Ethics Committee approved, single center study performed at Blekinge County Hospital, Karlskrona, Sweden. The AspireAssist® Aspiration Therapy System (AspireAssist) comprises a percutaneous gastrostomy tube (Atube) through which patients aspirate a portion of ingested meals from the stomach and an accessory siphon device that facilitates aspiration. The study was planned as a one year study, but 12 subjects wished to keep their device for up to 3 years. Results: Of 25 subjects, 22 subjects completed one year, 15 subjects 2 years, and 12 subjects completed 3 years. The mean weight loss for the 12 patients who completed 3 years was 26 kg with an excess weight loss (EWL) of mean 58%. On an Intent to treat basis, using last observation carry-forward, mean weight loss at the end of year 1,2, 3 was 48% (19 kg), 46% (18 kg), and 45% EWL (19 kg), respectively. Conclusions: The AspireAssist Aspiration Therapy System enables a low risk, reversible weight loss therapy with results approaching that of bariatric surgery.
4:03 PM
Abstract No. 86
Retrospective Review of percutaneous radiologic gastrostomy placement in patients with amyotrophic lateral sclerosis R. Fricke1, R. Pahls2, R. Li3, J. Meek3; 1University of Arkansas for Medical Sciences, Little Rock, AR; 2UAMS, Little Rock, AR; 3N/A, Little Rock, AR Purpose: Gastrostomy placement is indicated in ALS patients with malnutrition and weight loss, as these have been shown to be negative prognostic indicators (1). Radiologic gastrostomy placement carries the benefit of not requiring intubation and ventilator support necessary in endoscopic techniques. The purpose of this study is to retrospectively evaluate complication rate of percutaneous radiologic gastrostomy placement in patients with ALS. Materials: Twenty five patients (12 men and 13 women; mean age 66) with ALS received PRG placement between