Introduction & Objectives
\nBenign ureteroenteric strictures remain challenging, with frequent recurrence after conventional endoscopic treatment because
\nmechanical incision alone does not modulate fibroproliferative restenosis. Paclitaxel-dextran drug-coated balloons may provide local
\nantiproliferative therapy after stricture preparation. We evaluated the feasibility, safety and early radiological outcomes of adjuvant
\nElutax 3\u00ae after endoureterotomy for benign ureteroenteric strictures.<\/p>\n
Materials & Methods
\nSingle-centre observational case series of 15 consecutive patients treated with endoureterotomy followed by adjuvant inflation of a
\npaclitaxel-dextran drug-coated balloon (Elutax 3\u00ae, AR Baltic Medical, 2.2 \u00b5g\/mm\u00b2). The balloon was inflated at 8 atm for 5 minutes
\nover a 0.018-inch guidewire after standard endoscopic stricture incision. Radiological success was assessed by quarterly ultrasound
\nor CT scan and defined as absence of hydronephrosis or improvement compared with preoperative imaging at last follow-up. Safety
\noutcomes included perioperative complications and paclitaxel-related toxicity. Outcomes were interpreted against a historical
\ninstitutional cohort of endoureterotomy without DCB. Wilson 95% confidence intervals were calculated. Ethics committee approval
\nwas obtained.<\/p>\n
Results
\nMean age was 64.1\u00b111.7 years and 73.3% were male. Mean preoperative creatinine was 1.54\u00b10.57 mg\/dL, mean stricture length
\nwas 32.0\u00b14.9 mm, and mean time from urinary diversion to stricture diagnosis was 11.5\u00b114.2 months. Chronic kidney disease,
\ndiabetes mellitus and obesity were present in 53.3%, 26.7% and 26.7% of patients, respectively. Preoperative drainage consisted of
\nnephrostomy in 9 patients, ureteral stent in 2, and no drainage in 3. Collins-knife endoureterotomy was used in all cases. At a mean
\nfollow-up of 13.5\u00b13.5 months (median 14, range 7\u201318), radiological success was achieved in 10\/15 patients: 66.7% (95%CI 41.7\u2013
\n84.8%). One clinically relevant perioperative complication occurred (Clavien\u2013Dindo grade \u2265II; 6.7%). No systemic paclitaxel-related
\ntoxicity was observed. In the historical non-DCB cohort, success was 52.4% (95%CI 37.7\u201366.6%) after a longer mean follow-up of
\n26 months. Baseline variables were not significantly different between cohorts, although follow-up was significantly shorter in the
\nDCB group.<\/p>\n
Conclusions
\nAdjuvant paclitaxel-dextran DCB after endoureterotomy was technically feasible and showed a favourable safety profile, with no
\nsystemic paclitaxel-related toxicity. Early radiological success was 66.7%, numerically higher than our historical non-DCB
\nexperience, but this comparison is limited by small sample size and shorter follow-up. These preliminary findings support further
\ncontrolled prospective evaluation of paclitaxel-dextran DCBs as a biologically targeted adjunct in benign ureteroenteric strictures.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & Objectives Benign ureteroenteric strictures remain challenging, with frequent recurrence after conventional endoscopic treatment because mechanical incision alone does not modulate fibroproliferative restenosis. Paclitaxel-dextran drug-coated balloons may provide local antiproliferative therapy after stricture preparation. We evaluated the feasibility, safety … read more<\/a><\/p>","protected":false},"author":3,"featured_media":291,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-290","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/290","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/291"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=290"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=290"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=290"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}