Year 2019 / Volume 111 / Number 3
Case Report
A novel rescue maneuver for a distal dislodged lumen-apposing metal stent (LAMS): “LAMS-in-LAMS” technique

243-245

DOI: 10.17235/reed.2019.5924/2018

Maria Curieses Luengo, Claudia F. Consiglieri, Manuel Puga, Joan B. Gornals,

Abstract
Introduction: the appearance of the lumen-apposing metal stent (LAMS) has meant an authentic revolution. To date, the results are promising but it is necessary to note the technical incidents and LAMS-related complications. Case report: an EUS-transmural guided drainage using a HotAXIOS was planned for a 36-year-old man with oral intolerance due to a voluminous walled-off necrosis. The distal flange was left in the collection, but a total distal malposition occurred during the proximal flange delivery, despite correct apposition with visualization of the black mark. A rescue technique was performed inserting a second LAMS over-the-guidewire salvaging the initial failed transmural drainage. Discussion: This case is a reminder that in similar scenarios, extreme tension of the echoendoscope can cause a malfunction of the AXIOS stent delivery system, and lead to a total distal malposition. This “LAMS-in-LAMS” technique is feasible, effective, and a very helpful rescue technique in cases of dislodged LAMS.
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References
1. Ngamruengphong S, Kumbhari V, Tieu AH et al. EUS-guided rescue of early dislodgement of a lumen apposing stent. Gastrointest Endosc 2015; 82: 1124.
2. Tyberg A, Perez-Miranda M, Sanchez-Ocaña R et al. Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience. Endoscopic Int Open 2016;4: 276-278.
3. Tyberg A, Zerbo S, Barthet M et al. A novel technique for salvaging a dislodged lumen-apposing metal stent during creation of an endoscopic gastrojejunostomy. Gastrointest Endosc 2017; 49:1007-1008.
4. Ligresti D, Cipolletta F, Amata M, et al. Buried lumen-apposing metal stent (LAMS) following endoscopic ultrasound-guided gallbladder drainage: the LAMS-in-LAMS rescue treatment. Endoscopy. 2018; 50: 822-823.
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Curieses Luengo M, Consiglieri C, Puga M, Gornals J. A novel rescue maneuver for a distal dislodged lumen-apposing metal stent (LAMS): “LAMS-in-LAMS” technique . 5924/2018


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Publication history

Received: 16/09/2018

Accepted: 27/10/2018

Online First: 11/02/2019

Published: 04/03/2019

Article Online First time: 148 days

Article editing time: 169 days


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