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Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy - 23/08/11

Doi : 10.1016/j.gie.2007.10.063 
Juan M. Herrerias, MD, Jonathan A. Leighton, MD, Guido Costamagna, MD, Anthony Infantolino, MD, Rami Eliakim, MD, Doron Fischer, MD, David T. Rubin, MD, Howard D. Manten, MD, Eitan Scapa, MD, Douglas R. Morgan, MD, MPH, Ari J. Bergwerk, MD ⁎, Binyamin Koslowsky, MD, Samuel N. Adler, MD
Current affiliations: Hospital Virgen de la Macarena (J.M.H.), Seville, Spain, Mayo Clinic Arizona (J.A.L.), Scottsdale, Arizona, USA, Universita Cattolica del Sacro Cuore (G.C.), Rome, Italy, Thomas Jefferson University (A.I.), Philadelphia, Pennsylvania, USA, Rambam Medical Center (R.E., D.F.), Haifa, Israel, University of Chicago (D.T.R.), Chicago, Illinois, USA, University of Miami (H.D.M.), Miami, Florida, USA, Assaf Harofeh Medical Center (E.S.), Zerifin, Israel, University of North Carolina at Chapel Hill (D.R.M.), Chapel Hill, North Carolina, USA, Shaare Zedek Medical Center (A.B.), Jerusalem, Israel, Bikur Holim Hospital (B.K., S.N.A.), Jerusalem, Israel 

Reprint requests: Ari J. Bergwerk, MD, Gastroenterology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel.

Seville, Spain, Rome, Italy, Haifa, Zerifin, Jerusalem, Israel, Scottsdale, Arizona, Philadelphia, Pennsylvania, Chicago, Illinois, Miami, Florida, Chapel Hill, North Carolina, USA

Abstract

Background

Capsule endoscopy (CE) of the small bowel has become a standard diagnostic tool, but there have been concerns regarding the risk of capsule retention in certain high-risk groups. The Agile patency system, an ingestible and dissolvable capsule with an external scanner, was developed to allow physicians to perform CE with greater confidence that the capsule will be safely excreted in patients at risk for capsule retention.

Objective

Our purpose was to assess the ability of the device to help physicians identify which patients with known strictures may safely undergo CE.

Design

Patients with known strictures ingested the new patency capsule and underwent periodic scanning until it was excreted. The intestinal tract was considered to be sufficiently patent if the capsule was excreted intact or if the capsule was not detected by the scanner at 30 hours after ingestion. If patency was established, then standard CE was performed.

Setting

International multicenter study.

Patients

A total of 106 patients with known strictures.

Intervention

Agile patency system.

Main Outcome Measurements

Performance and safety of Agile patency system.

Results

A total of 106 patients ingested the patency capsule. Fifty-nine (56%) excreted it intact and subsequently underwent CE. There were no cases of capsule retention. Significant findings on CE were found in 24 (41%). There were 3 severe adverse events.

Conclusions

These results suggest that the Agile patency system is a useful tool for physicians to use before CE in patients with strictures to avoid retention. This group of patients may have a high yield of clinically significant findings at CE. This capsule may determine whether patients who have a contraindication to CE may safely undergo CE and obtain useful diagnostic information.

El texto completo de este artículo está disponible en PDF.

Abbreviations : CE, RFID, SBFT


Esquema


 See CME section; p. 932.


© 2008  American Society for Gastrointestinal Endoscopy. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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