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Comparison of Balloon- and Mushroom-Retained Large-Bore Gastrostomy Catheters

Brian Funaki1, Ryan Peirce1, Jonathan Lorenz1, Paul B. Menocci1, Jordan D. Rosenblum1, Christopher Straus1, Thuong Van Ha1, Jeffrey A. Leef1 and George X. Zaleski2

1 Department of Radiology, MC 2026, The University of Chicago Hospitals, 5841 S. Maryland Ave., Chicago, IL 60637.
2 Racine Radiologist Group, 3803 Spring St., Rm. 208, Racine, WI 53405.



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  		Fig. 1. —Photograph of gastrostomy catheters used in our study. Shown at top of photograph is 18-French single-use balloon-retained replacement gastrostomy catheter (Microvasive; Boston Scientific, Nattick MA). At bottom of photo is 20-French removable mushroom-retained catheter (Pull-PEG; Medical Innovations, Draper, UT), which is pulled by snare from patient's mouth into stomach. Plastic dilator is then removed, and feeding adapter and skin bolster are attached.

 


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  		Fig. 2A. —Drawings show balloon-retained gastrostomy placement. Catheter is inserted over guidewire via peel-away sheath into stomach. Note T-fasteners are in place.

 


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  		Fig. 2B. —Drawings show balloon-retained gastrostomy placement. After insertion, balloon is inflated with saline to secure in stomach.

 


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  		Fig. 3A. —Drawings show mushroom-retained gastrostomy placement. Catheter is pulled by snare into stomach. Dilator attached to tube enlarges puncture site as it is pulled through stomach and abdominal wall. T-fastener is in place.

 


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  		Fig. 3B. —Drawings show mushroom-retained gastrostomy placement. After tube is pulled through abdominal wall, dilator and T-fastener are cut. Skin fixation and bolus-feeding adaptor are then attached.

 

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