Figures (4)  Tables (1)

    • Figure 1. 

      Illustration of the duodenal HANAROSTENT®. Shown here is a duodenal HANAROSTENT® placed for palliation of GDOO (in this case secondary to a pancreatic malignancy). A concerted effort is made to not obscure the major papilla in case of a future need for biliary stenting. The drawing illustrates (in gold) the radiopaque markers at the stent ends and in the center. GDOO, gastroduodenal outlet obstruction.

    • Figure 2. 

      Fluoroscopic view of the duodenal HANAROSTENT® immediately post-deployment across a long and tortuous segment of gastroduodenal obstruction. Twelve radiopaque markers are visible (4 proximal [yellow arrows], 4 middle [blue arrows], and 4 distal [white arrows]) and are useful in fluoroscopic stent visualization to facilitate precise endoscopic placement.

    • Figure 3. 

      Placement of the duodenal HANAROSTENT® in a 61-year-old male with a metastatic neuroendocrine tumor. (a) A large, ulcerated mass is found in the gastric body causing severe luminal narrowing. (b) A 22 × 90 mm duodenal HANAROSTENT® is advanced over a guidewire through the region of greatest narrowing in the gastric antrum. c Appropriate positioning of the stent is confirmed fluoroscopically. d Deployed duodenal HANAROSTENT® as seen endoscopically and (e) fluoroscopically. f An upper GI series confirms stent patency.

    • Figure 4. 

      Successful duodenal HANAROSTENT® placement as seen on fluoroscopic images obtained at the terminus of the index upper endoscopy. Patient 2 (a), patient 3 (b), patient 6 (c), and patient 7 (d).

    • Patient Age, years Gender Stent size, mm Etiology of GDOO Technical success Clinical success Adverse events Follow-up time, months
      Primary gastroduodenal origin
      1 44 M 22×90 Gastric adenocarcinoma with signet-ring Yes Yes No 12.0
      cell features
      2 52 M 22×90 Duodenal carcinoma Yes Yes No 2.3
      3 51 M 22×90 Signet-ring cell carcinoma, unknown Yes Yes No 1.0a
      primary origin
      Other primary tumor origin
      4 61 M 22×90 Metastatic neuroendocrine tumor Yes Yes No 5.9a
      5 48 F 22×120 Metastatic ovarian carcinoma Yes Yes No 5.1
      6 60 F 22×120 Metastatic ovarian carcinoma Yes Yes No 1.4a
      7 56 M 22×90 Unresectable pancreatic adenocarcinoma Yes Yes No 7.5
      GDOO, gastroduodenal outlet obstruction. a Patient died at the end of the follow-up period.

      Table 1. 

      Summary of duodenal HANAROSTENT® case features and outcomes