9
NOTE: Ensure that the red safety lock is not inadvertently removed prior to steps 1-6
above.
Stenting Procedure
Single Stent
NOTE: For best results, keep the wire guide wet.
1. Unlock the wire guide, if using the fusion wire guide locking device.
2. Backload the device over a pre-positioned wire guide, ensuring the wire guide exits
the wire guide hub.
3. Introduce the device in short increments into the accessory channel of the
duodenoscope. With the elevator open, continue advancing the device in short
increments until it is endoscopically visualized exiting the duodenoscope.
4. Under fluoroscopic guidance, with the elevator open, pass the stent delivery system
through the papilla and into the common bile duct. Advance the device in short
increments until the stent is fluoroscopically visualized through the stricture. Confirm
desired stent position fluoroscopically. NOTE: For transpapillary placement, reference
the yellow endoscopic marker for stent positioning. A stent bridging the papilla
should extend beyond the papilla and into the duodenum approximately 0.5 cm after
deployment.
5. Prior to deploying stent, remove the red safety lock. NOTE: Ensure that the red safety
lock is not inadvertently removed prior to this step.
6. Under fluoroscopic guidance, with the elevator open, begin deployment of the
stent by holding the wire guide hub stationary and slowly pulling back on the handle.
Simultaneously maintain stent position during deployment by withdrawing the delivery
system from the duodenoscope. WARNING: Do not advance the delivery system up into
the bile duct after stent deployment has been initiated. CAUTION: The delivery system
cannot be readvanced over the stent to recapture the stent during deployment.
7. Continue simultaneously pulling back on the handle and withdrawing the delivery
system until you fluoroscopically confirm that the stent is completely deployed. For
transpapillary placement, endoscopic confirmation of complete stent deployment may
also be used.
8. While maintaining wire guide position, with the elevator open, carefully remove
the delivery system from within the expanded stent. Remove the delivery system from
the duodenoscope while monitoring the position of the stent fluoroscopically. NOTE:
Fluoroscopically ensure the stent has expanded sufficiently to allow for safe removal of
the tip.
Side-by-Side Stents
NOTE: For best results, keep wire guides wet.
1. Unlock the wire guide, if using the Fusion Wire Guide Locking Device.
2. Backload the device over a pre-positioned wire guide, ensuring the wire guide exits
the wire guide hub
3. Introduce the device in short increments into the accessory channel of the
duodenoscope. With the elevator open, continue advancing the device in short
increments until it is endoscopically visualized exiting the duodenoscope.
4. Under fluoroscopic guidance, with the elevator open, pass the stent delivery system
through the papilla and into the common bile duct. Advance the device in short
