Background & Objectives: Cholangiocarcinoma is a malignant tumor of the biliary tract epithelium. Although it is not a common tumor, it has a high mortality rate so that the five-year survival of the patients is only 5%. Most patients are found to have irresectable tumor on initial presentation. These have led to an emphasis on the role of palliative treatment.

 Methods: 43 patients with Cholangiocarcinoma (from 1996-2003) based on ERCP were included in this study. Demographic aspects, clinical and Para clinical manifestations as well as the risk factors were investigated and survival rates of the patients were compared with or without stenting of the biliary tract.

 Results: 27 patients (62.8%) were male and 16(37.2%) were female with mean age of 65. Ulcerative colitis accompanied with PSC was diagnosed in just one case. Jaundice, weight loss and pruritus were the main complaints of the patients. Twenty-seven cases received stent in biliary tract through ERCP while no treatment was performed in other patients due to technical failure or patients’ disagreement. Mean survival time for all patients was 125 days. There were no statistically significant difference between survival rate of the patients with stent and without it.

 Conclusion: In this study cholangiocarcinoma in our patients was less frequently seen to accompany UC and PSC. Curative surgical resection is not possible in the majority of cases, and palliative treatment only decreases the severity of the symptoms but has no significant effect on survival.

  Background & Objectives : Patients with esophageal SCC and GEJ adenocarcinoma have a poor prognosis. The advanced stage tumor is not amenable to cure and requires palliation, specially to relief dysphagia and to improve quality of life. Esophageal stenting has been shown to be faster, and longer lasting method of palliation. Esophageal expandable stents have been available recently in IRAN. The aim of this study was to report the results of our experience to relief dysphagia by means of stents, specially plastic removable types.

  Methods: This was a prospective trial in 60 patients with strictures due to malignant esophageal and /or GEJ cancers and those who had undergone anastomotic procedure during 2001 to 2005. These patients referred to endoscopy clinic of Tabriz Immam hospital for stenting. Dysphagia was scored according to a 5-point scale before stenting, 3 days after, and later during follow-up period of a mean of 7.6±6.6 months. Barium study and endoscopy was done for evaluation of site and length of stricture, and its etiology. Strictures were dilated up to 15 mm before stenting. The data were analyzed using correlation test, Chi-sqare and T- tests.

  Results: Covered metallic Wallstent was used in 12 patients removable covered polyflex stents in 47 and double lumen metal stent in only one case. Stents were successfully deployed in all cases. Dysphagia improved significantly by all stent types compared with the presenting status, after 3 days (p<0001) and during follow up period (p<0.05). Distal displacement of stents was seen in 16 (32%) patients, all of which happened during 1-3 months after insertion. In polyflex stents, the way restored by endoscopic intervention. Tumor overgrowth at the end of stent was seen in 4(8%) of the cases. Mean period of survival was 7.6± 6.6 months. In no case was the death directly attributable to the procedure.

  Conclusions: Self-expandable plastic stents (SEPS), have favorable efficacy in palliating dysphagia. Their insertion is easy, with low risk and successful and associated with a lower rate of complications, morbidity and mortality in majority of the patients.

  Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period.

  Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables.

  Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant

  Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.