Year 2019 / Volume 111 / Number 6
Original
A retrospective, multicenter analysis of incidents associated with Axios™ lumen-apposing stents

419-424

DOI: 10.17235/reed.2019.6147/2018

Sergio Bazaga Pérez de Rozas, Ana Yaiza Carbajo, Francisco Javier Garcia-Alonso, David Martí, Vicente Sánchiz Soler, Belén Martínez Moreno, Jose Ramón Aparicio Tormo, Rafael Pedraza Sanz, Juan Vila Costas, Enrique Vázquez-Sequeiros, Rosanna Villanueva Hernández, J. Alexander Jordán Castro, Marcos Jiménez Palacios, Carlos de la Serna Higuera, Manuel Perez-Miranda Castillo,

Abstract
Introduction: there is controversy with regard to the risks associated with lumen-apposing metal stents (LAMSs), with significant variations between available reports. Objectives: to describe the types and proportions of complications that arise during the permanence time and removal of Axios™ LAMS. Furthermore, the relationship between patency time, therapeutic target and the presence of complications was also described. Methods: a retrospective, multicenter case series study was performed of all patients with an implanted LAMS to access extra-luminal structures during 2017. Only technically successful cases were recorded. Results: a total of 179 patients from seven sites (range, 4-68 cases/site) were included in the study, with a mean age of 64.3 years (SD: 15.8; range: 24.6-98.8 years) and 122 (68.2%) were male. Most common indications included encapsulated necrosis (58, 32.4%), pseudocysts (31, 17.3%) and gallbladder drains (26, 14.5%). Complications during LAMS stay were reported in 19 patients (10.9%); stent lumen or gastroduodenal obstruction (8, 4.5%) and bleeding (7, 3.9%) were the most common. LAMS were not removed in 86 (48%) patients due to the following reasons: a permanent stent was used (46, 53.5%), loss to follow-up (18, 20.9%), patient demise (16, 18.6%) and stent migration (6, 7%). Five (5.4%) complications were reported during stent removal, which were three bleeds and two perforations. No association was found between stent duration and complications (p = 0.67). Conclusion: complications secondary to LAMS insertion are uncommon but may be serious. This study found no association between complications and stent duration.
Share Button
New comment
Comments
No comments for this article
References
1. Vazquez-Sequeiros E, Baron TH, Pérez-Miranda M, Sánchez-Yagüe A, Gornals J, Gonzalez-Huix F, et al. Evaluation of the short- and long-term effectiveness and safety of fully covered self-expandable metal stents for drainage of pancreatic fluid collections: results of a Spanish nationwide registry. Gastrointest Endosc. 2016 Sep;84(3):450–457.e2.
2. Siddiqui AA, Adler DG, Nieto J, Shah JN, Binmoeller KF, Kane S, et al. EUS-guided drainage of peripancreatic fluid collections and necrosis by using a novel lumen-apposing stent: a large retrospective, multicenter U.S. experience (with videos). Gastrointest Endosc. 2016 Apr;83(4):699–707.
3. Rinninella E, Kunda R, Dollhopf M, Sanchez-Yague A, Will U, Tarantino I, et al. EUS-guided drainage of pancreatic fluid collections using a novel lumen-apposing metal stent on an electrocautery-enhanced delivery system: a large retrospective study (with video). Gastrointest Endosc. 2015 Dec;82(6):1039–46.
4. Kahaleh M, Shami V, Conaway M, Tokar J, Rockoff T, De La Rue S, et al. Endoscopic Ultrasound Drainage of Pancreatic Pseudocyst: A Prospective Comparison with Conventional Endoscopic Drainage. Endoscopy. 2006 Apr;38(4):355–9.
5. Sriram P, Kaffes A, Rao G, Reddy D. Endoscopic Ultrasound-Guided Drainage of Pancreatic Pseudocysts Complicated by Portal Hypertension or by Intervening Vessels. Endoscopy. 2005 Feb 24;37(03):231–5.
6. Fabbri C, Luigiano C, Marsico M, Cennamo V. A rare adverse event resulting from the use of a lumen-apposing metal stent for drainage of a pancreatic fluid collection: “the buried stent.” Gastrointest Endosc. 2015 Sep;82(3):585–7.
7. Bang JY, Hasan M, Navaneethan U, Hawes R, Varadarajulu S. Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: May not be business as usual. Gut. 2017 Dec;66(12):2054–6.
8. Stecher S, Simon P, Friesecke S, Glitsch A, Kühn J, Lerch M, et al. Delayed severe bleeding complications after treatment of pancreatic fluid collections with lumen-apposing metal stents. Gut. 2017 Oct;66(10):1871–2.
9. Krafft MR, Shah-Khan SM, Hsueh W, Nasr J. Endoscopic retrieval of a buried lumen-apposing metal stent through an indwelling lumen-apposing metal stent. VideoGIE an Off video J Am Soc Gastrointest Endosc. 2018 Apr;3(4):117–8.
10. Mehta N, Abushahin A, Franco M, Stevens T, Chahal P, Vargo J, et al. Endoscopic retrieval of a lumen-apposing metal stent complicated by inward migration after cystogastrostomy. Endoscopy. 2018 Aug 8;
11. DeSimone ML, Asombang AW, Berzin TM. Lumen apposing metal stents for pancreatic fluid collections: Recognition and management of complications. World J Gastrointest Endosc. 2017 Sep 16;9(9):456–63.
12. Cotton PB, Eisen GM, Aabakken L, Baron TH, Hutter MM, Jacobson BC, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010 Mar;71(3):446–54.
13. Gornals JB, De la Serna-Higuera C, Sánchez-Yague A, Loras C, Sánchez-Cantos AM, Pérez-Miranda M. Endosonography-guided drainage of pancreatic fluid collections with a novel lumen-apposing stent. Surg Endosc. 2013 Apr 12;27(4):1428–34.
14. Ang T, Kongkam P, Kwek A, Orkoonsawat P, Rerknimitr R, Fock K. A two-center comparative study of plastic and lumen-apposing large diameter self-expandable metallic stents in endoscopic ultrasound-guided drainage of pancreatic fluid collections. Endosc Ultrasound. 2016;5(5):320.
15. Hammad T, Khan MA, Alastal Y, Lee W, Nawras A, Ismail MK, et al. Efficacy and Safety of Lumen-Apposing Metal Stents in Management of Pancreatic Fluid Collections: Are They Better Than Plastic Stents? A Systematic Review and Meta-Analysis. Dig Dis Sci. 2018 Feb 27;63(2):289–301.
16. Chandran S, Efthymiou M, Kaffes A, Chen JW, Kwan V, Murray M, et al. Management of pancreatic collections with a novel endoscopically placed fully covered self-expandable metal stent: a national experience (with videos). Gastrointest Endosc. 2015 Jan;81(1):127–35.
17. Walter D, Will U, Sanchez-Yague A, Brenke D, Hampe J, Wollny H, et al. A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a prospective cohort study. Endoscopy. 2014 Sep 30;47(01):63–7.
18. Siddiqui AA, Adler DG, Nieto J, Shah JN, Binmoeller KF, Kane S, et al. EUS-guided drainage of peripancreatic fluid collections and necrosis by using a novel lumen-apposing stent: a large retrospective, multicenter U.S. experience (with videos). Gastrointest Endosc. 2016 Apr;83(4):699–707.
19. Kalva NR, Vanar V, Forcione D, Bechtold ML, Puli SR. Efficacy and Safety of Lumen Apposing Self-Expandable Metal Stents for EUS Guided Cholecystostomy: A Meta-Analysis and Systematic Review. Can J Gastroenterol Hepatol. 2018;2018:7070961.
20. Abdel-Aziz Y, Renno A, Hammad T, Nawras A. Rare Esophageal Migration of AXIOS Stent Used for Walled-off Pancreatic Necrosis Drainage. ACG case reports J. 2017;4:e73.
21. Ligresti D, Cipolletta F, Amata M, Cimavilla M, Traina M, Tarantino I. Buried lumen-apposing metal stent (LAMS) following endoscopic ultrasound-guided gallbladder drainage: The LAMS-in-LAMS rescue treatment. Endoscopy. 2018;50(8):822–3.
22. Garcia-Alonso F, Sanchez-Ocana R, Peñas-Herrero I, Law R, Sevilla-Ribota S, Torres-Yuste R, et al. Cumulative risks of stent migration and gastrointestinal bleeding in patients with lumen-apposing metal stents. Endoscopy. 2018 Apr;50(04):386–95.
Related articles

Letter

When eating becomes a real nightmare

DOI: 10.17235/reed.2023.10025/2023

Letter

Ischemic gastritis and severe diabetic ketoacidosis

DOI: 10.17235/reed.2020.7655/2020

Letter

Hemorrhagic complications following paracentesis

DOI: 10.17235/reed.2020.6914/2020

Original

Usefulness of an intra-gastric balloon before bariatric surgery

DOI: 10.17235/reed.2017.4624/2016

Original

Multicenter study on the safety of bariatric endoscopy

DOI: 10.17235/reed.2017.4499/2016

Letter to the Editor

Intramural gastric hematoma in the context of an acute pancreatitis

DOI: 10.17235/reed.2017.4494/2016

Citation tools
Bazaga Pérez de Rozas S, Carbajo A, Garcia-Alonso F, Martí D, Sánchiz Soler V, Martínez Moreno B, et all. A retrospective, multicenter analysis of incidents associated with Axios™ lumen-apposing stents. 6147/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1452 visits.
This article has been downloaded 461 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 28/12/2018

Accepted: 01/02/2019

Online First: 25/04/2019

Published: 07/06/2019

Article revision time: 27 days

Article Online First time: 118 days

Article editing time: 161 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology