Lumen-apposing metal stents in interventional endoscopy: a state-of-the-art review with focus on technical and clinical successes and complications

Kadah, Anas; Khoury, Tawfik; Mari, Amir; Mahamid, Mahmud; Sbeit, Wisam

doi:10.1097/meg.0000000000001571

Cited by 5 publications

(4 citation statements)

References 67 publications

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“…[ 16 17 27 ] Above all, what looks crucial to define is the adequate working setting, the essential need of a radiologic room, and a specialized team of interventional radiologists and pancreatobiliary surgeons. It is known, indeed, that LAMS placement has a not negligible rate of intraprocedural adverse events, such as technical failure, misdeployment, bleeding, and perforation[ 9 ] to manage whom fluoroscopy is needed, as well as radiological and surgical facilities.…”

Section: Discussionmentioning

confidence: 99%

“…In the last years, several studies have been published on the technical and clinical outcomes of LAMS[ 8 9 10 11 12 ] and their use and indication is expanding. To date, LAMS has three on-label indications: pancreatic fluid collection (PFC) drainage (PFCD),[ 13 14 ] secondary to acute pancreatitis, biliary drainage (BD)[ 15 16 ] for relieving biliary obstruction after failed ERCP, and gallbladder drainage (GBD)[ 17 ] for treatment of acute cholecystitis in high-risk surgical patients.…”

Section: Introductionmentioning

confidence: 99%

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Lumen-apposing metal stents

Fabbri

Coluccio

Binda

et al. 2022

Endoscopic Ultrasound

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Background and Objectives: EUS-guided transluminal drainage has increasingly developed, especially after the era of lumen-apposing metal stent (LAMS): a fully covered, barbell-shaped, metal stent with anti-migratory properties allowing direct therapeutic interventions through a wide and short channel. The aim of this survey is to investigate the current management of patients undergoing LAMS placement nationwide. Materials and Methods: Forty-eight questions were submitted to Italian centers about expertise, peri- and intra-procedural aspects, budget/refund, and future perspectives. Statistical analyzer was SPSS®. Results: Thirty-six centers completed the survey. Indications for LAMS positioning are pancreatic fluid collection drainage (PFCD, 97.2%), biliary drainage (BD, 80.5%), gallbladder drainage (GBD, 75%), and gastroentero-anastomosis (GEA, 19.4%). A total of 77.7% of the endoscopists perform only on-label procedures and 22.2% both on-label and off-label. 38.8% attended a training preliminary course, 27.7% were just supported by an expert, 22.2% had both the opportunities, and 8.3% none of them. Management of antiplatelets and sedation protocol is very heterogeneous. Only 50% involves a multidisciplinary meeting and 30.5% has a specialized clinic for follow-up. Acid suppression is usually continued after PFCD. The type and timing of postprocedural imaging varies widely. 8.3% of the endoscopists work without fluoroscopy. Refund for LAMS is mostly not guaranteed. Main future growing indications appear to be BD, GBD, and GEA (69.4%, 55.5%, and 55.5%, respectively). Conclusions: This is the first survey assessing the state of the art on LAMS almost 10 years after their advent. There are currently wide variations in practice nationwide, which demonstrates a pressing need to define technical, qualitative, and peri-procedural requirements to carry out this procedure, toward a standardization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lumen-apposing metal stents

Fabbri

Coluccio

Binda

et al. 2022

Endoscopic Ultrasound

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show abstract

“…The specific cause of this complication is not clear. Most of the buried stents were case reports, but in one recent review concerning complications of LAMS, occurrence rates of buried stent in PFC, bile duct and gallbladder were 0.07%, 0 and 0.59%, respectively ( 54 ).…”

Section: Complications Of Ec-lamsmentioning

confidence: 99%

Current uses of electro-cautery lumen apposing metal stents in endoscopic ultrasound guided interventions

Liu

et al. 2022

Front. Med.

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The electro-cautery lumen apposing metal stent (EC-LAMS) is a newly developed device that integrates the electro-cautery cyctotome with the one-step metal stent delivery and releasing system in recent years. LAMS was first designed to complete the drainage of pancreatic fluid collection under endoscopic ultrasound guidance, and the technological innovation of EC-LAMS has made more off-labeled indications of endoscopic intervention for gastrointestinal diseases realized, such as abdominal fluid drainage, bile duct, or gallbladder drainage through stomach or duodenum, gastrointestinal anastomosis, and the establishment of fistulous channel for further endoscopic operation when necessary. The unique feature of this metal stent is that it has the design of a saddle shape and a large lumen, and can almost connect the adjacent structures to minimize the risk of perforation and leakage. Compared with traditional LAMS, EC-LAMS, an advanced integrated device, can greatly simplify the endoscopic process, shorten the procedure time and reduce the technical difficulty, thus it can help endoscopists complete more complex endoscopic interventions. In this review, we discuss the state of art with regard to EC-LAMS and its endoscopic process, current indications, outcomes, adverse events, and future application prospects.

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“…Además, permite realizar la técnica "freehand", lo que disminuye la dificultad a nivel técnico del procedimiento. Sin embargo, debido a su morfología y calibre, no pueden utilizarse para el abordaje de la vía biliar intrahepática, restringiéndose su uso para el drenaje biliar por CDS 35 .…”

Section: Vía Transluminal: Hepaticogastrostomía Vs Coledocoduodenostomíaunclassified

When ERCP is not possible: ultrasound endoscopy guided biliary drainage

2022

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Resumen La Colangiopancreatografía Retrógrada Endoscópica (CPRE) constituye la técnica de elección para el drenaje de la vía biliar, ya sea en casos de obstrucción biliar benigna o maligna. Sin embargo, una vez esta técnica no resulta eficaz o factible, tenemos a nuestra disposición varias alternativas, siendo la más utilizada hasta ahora la colangiografía transhepática percutánea (CTPH). Sin embargo, a día de hoy el drenaje biliar guiado por ecoendoscopia (USE-BD) constituye una alternativa cada vez más factible a la radiología intervencionista o la cirugía. En esta revisión se abordarán los resultados de este tipo de drenaje en comparación con los demás, así como los diferentes tipos de técnicas disponibles y sus resultados en la práctica clínica.

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Lumen-apposing metal stents in interventional endoscopy: a state-of-the-art review with focus on technical and clinical successes and complications

Cited by 5 publications

References 67 publications

Lumen-apposing metal stents

Lumen-apposing metal stents

Current uses of electro-cautery lumen apposing metal stents in endoscopic ultrasound guided interventions

When ERCP is not possible: ultrasound endoscopy guided biliary drainage

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