Endoscopic removal of a lumen-apposing metal stent that migrated into the walled-off necrosis during the first drainage procedure

Abstract

Endoscopic removal of a lumen-apposing metal stent that migrated into the walled-off necrosis during the first drainage procedure A 43-year-old man with severe alcoholic acute pancreatitis complicated by infected walled-off necrosis (WON) (▶ Fig. 1) was referred to our hospital. An endoscopic ultrasound (EUS)-guided transluminal drainage was performed using a GF-UCT260 echoendoscope (Olympus Medical Systems, Tokyo, Japan) and a 15-mm lumen-apposing metal stent (LAMS; Hot AXIOS; Boston Scientific, Marlborough, Massachusetts, USA) was ▶ Fig. 2 Fluoroscopic images showing: a a 15-mm lumen-apposing metal stent (LAMS) that had migrated into the walled-off necrosis (WON) during the first drainage session; b the migrated LAMS being moved deeper into the WON using a balloon catheter (white arrow); c an additional 20-mm LAMS being inserted along the same guidewire under fluoroscopic guidance.

Retrieval of a misdeployed lumen‐apposing metal stent in walled‐off necrosis by a parallel withdrawal technique using a double‐channel endoscope

“…Endoscopic ultrasound‐guided transluminal drainage (EUS‐TD) with a lumen‐apposing metal stent (LAMS) is a useful treatment for walled‐off necrosis (WON) 1–3 . With the increasing use of LAMS, associated adverse events such as misdeployment might happen 4 . Here we present a technique for endoscopic retrieval of a misdeployed LAMS in WON.…”

“…[1][2][3] With the increasing use of LAMS, associated adverse events such as misdeployment might happen. 4 Here we present a technique for endoscopic retrieval of a misdeployed LAMS in WON. A 45-year-old man presented with epigastric pain and fever for 2 weeks.…”

Mishaps with EUS–guided lumen-apposing metal stents in therapeutic pancreatic EUS: management and prevention

“…Perhaps a larger lumen diameter can be chosen for the second stent to facilitate later retrieval. [ 7 ]…”

To-and-fro balloon technique for deployment of a lumen-apposing metal stent in highly solid walled-off necrosis of the pancreas

“…Inadequate expansion of the LAMS flanges may result in adverse events including stent migration and bleeding 5 . The to-and-fro balloon technique presented here ( Video 1 ) would further expand the indications of the LAMS for a symptomatic WON.…”