CT-guided percutaneous gastrostomy using needle puncture sequential coaxial dilation for high-risk patients with...

Evaluates the safety, efficacy, and nutritional outcomes of needle puncture sequential coaxial dilation technique in high-risk patients requiring long-term enteral nutrition.

This retrospective single-center study included 127 consecutive patients (mean age 67.4 ± 12.3 years; mean ASA 3.2 ± 0.7) who underwent CT-guided percutaneous gastrostomy using the needle puncture sequential coaxial dilation technique between January 2020 and December 2025. Notably, 89 patients (70.1%) had contraindications to PEG and 103 patients (81.1%) were unsuitable for surgical gastrostomy. Nutritional parameters including serum albumin, prealbumin, and body mass index (BMI) were assessed at baseline, 3 months, and 6 months post-procedure.

Technical success was achieved in 126 of 127 patients (99.2%). Major complications occurred in 0 patients (0%), and minor complications in 16 patients (12.6%). Nutritional outcomes demonstrated significant improvement: serum albumin increased from 2.8 ± 0.6 g/dL to 3.4 ± 0.5 g/dL at 3 months (p<0.001); prealbumin increased from 14.2 ± 3.8 mg/dL to 22.7 ± 4.2 mg/dL at 3 months (p<0.001); BMI increased from 18.7 ± 3.2 kg/m² to 20.1 ± 3.1 kg/m² at 6 months (p<0.01). Mean duration of enteral nutrition support was 147.3 ± 42.6 days.

CT-guided percutaneous gastrostomy using needle puncture sequential coaxial dilation is a safe and effective enteral access technique for high-risk patients with contraindications to conventional PEG/PRG approaches. The technique demonstrates excellent technical success (99.2%), minimal complications (0% major), and significant nutritional improvement, providing a viable nutritional support solution for patients who would otherwise be excluded from enteral feeding access.