Journal of vascular and interventional radiology : JVIR · 2009
Randomized comparison of nasolacrimal cryoplasty versus plastic lacrimal stenting in the management of epiphora in adults.
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lanciego Carlos, Navarro Sofía, Velasco Javier, Perea Miguel, Cuena-Boy Rafael, García-García Lorenzo
Аннотация
PURPOSE: To evaluate the efficacy of plastic polyurethane stents compared with nasolacrimal cryoplasty in the management of epiphora in adults.
MATERIALS AND METHODS: Patients (N = 37; mean age, 64 years; range, 34-86 y; six men, 31 women) with severe epiphora with partial/complete obstruction of the nasolacrimal system were randomized to have a plastic stent inserted (n = 19) or to undergo balloon dilation cryoplasty (n = 18). Both procedures were conducted on an outpatient basis. Patency was assessed with Kaplan-Meier curves.
RESULTS: Initial technical success rate and immediate resolution of epiphora was complete in all cases. At 6 months of follow-up, outcomes were already significantly different between the treatment groups and hence the study was discontinued. Plastic stent placement achieved a primary patency rate of 59.6% at 6 months, compared with 12.4% in the cryoplasty group (P < .0004). Multivariate analysis indicated that other measured variables (sex, age, etiology, previous treatment, and the interventional radiologist's expertise) had no significant effect on the outcomes (P > .05).
CONCLUSIONS: Initial success was good in both treatment groups, with nasolacrimal plastic stent placement achieving a level of primary patency superior to the cryoplasty procedure for the relief of epiphora on short-term follow-up. However, long-term outcome evaluation is needed before stent placement can be recommended as an alternative to more established surgical procedures.
MATERIALS AND METHODS: Patients (N = 37; mean age, 64 years; range, 34-86 y; six men, 31 women) with severe epiphora with partial/complete obstruction of the nasolacrimal system were randomized to have a plastic stent inserted (n = 19) or to undergo balloon dilation cryoplasty (n = 18). Both procedures were conducted on an outpatient basis. Patency was assessed with Kaplan-Meier curves.
RESULTS: Initial technical success rate and immediate resolution of epiphora was complete in all cases. At 6 months of follow-up, outcomes were already significantly different between the treatment groups and hence the study was discontinued. Plastic stent placement achieved a primary patency rate of 59.6% at 6 months, compared with 12.4% in the cryoplasty group (P < .0004). Multivariate analysis indicated that other measured variables (sex, age, etiology, previous treatment, and the interventional radiologist's expertise) had no significant effect on the outcomes (P > .05).
CONCLUSIONS: Initial success was good in both treatment groups, with nasolacrimal plastic stent placement achieving a level of primary patency superior to the cryoplasty procedure for the relief of epiphora on short-term follow-up. However, long-term outcome evaluation is needed before stent placement can be recommended as an alternative to more established surgical procedures.