Safety and efficacy of a novel electrocautery-enhanced lumen-apposing metal stent in interventional EUS procedures (with video)

Mangiavillano, Benedetto; Moon, Jong Ho; Crinò, Stefano Francesco; Larghi, Alberto; Pham, Khanh Do-Cong; Teoh, Anthony Yuen Bun; Paduano, Danilo; Lee, Yun Nah; Yoo, Hae Won; Shin, Il Sang; Rizzatti, Gianenrico; Robles-Medranda, Carlos; Oleas, Roberto; Bellocchi, Maria Cristina Conti; Auriemma, Francesco; Lamonaca, Laura; Spatola, Federica; Conigliaro, Rita; Facciorusso, Antonio; Gabbrielli, Armando; Repici, Alessandro

doi:10.1016/j.gie.2021.07.021

Cited by 56 publications

(42 citation statements)

References 20 publications

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“…It should be noted that all the included RCTs testing EUS-BD were published before the implementation in the clinical practice of LAMS; hence, our findings are not applicable to these newer devices, which indeed showed very promising results in this setting [23][24][25]. For a recent large multicenter study, on 239 patients that underwent EUS-CD using LAMS, technical success was reported in 93.3% of the cases, while clinical success was obtained in 96.2% of the patients in which technical success was achieved [26].…”

Section: Discussionmentioning

confidence: 81%

Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis

Facciorusso

Mangiavillano

Paduano

et al. 2022

Cancers

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There is scarce evidence on the comparison between different methods for the drainage of distal malignant biliary obstruction (DMBO) after endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we performed a network meta-analysis to compare the outcomes of these techniques. We searched main databases through September 2021 and identified five randomized controlled trials. The primary outcome was clinical success. The secondary outcomes were technical success, overall and serious adverse event rate. Percutaneous trans-hepatic biliary drainage was found to be inferior to other interventions (PTBD: RR 1.01, 0.88–1.17 with EUS-choledochoduodenostomy (EUS-CD); RR 1.03, 0.86–1.22 with EUS-hepaticogastrostomy (EUS-HG); RR 1.42, 0.90–2.24 with surgical hepaticojejunostomy). The comparison between EUS-HG and EUS-CD was not significant (RR 1.01, 0.87–1.17). Surgery was not superior to other interventions (RR 1.40, 0.91–2.13 with EUS-CD and RR 1.38, 0.88–2.16 with EUS-HG). No difference in any of the comparisons concerning adverse event rate was detected, although PTBD showed a slightly poorer performance on ranking analysis (SUCRA score 0.13). In conclusion, all interventions seem to be effective for the drainage of DMBO, although PTBD showed a trend towards higher rates of adverse events.

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Section: Discussionmentioning

confidence: 81%

Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis

Facciorusso

Mangiavillano

Paduano

et al. 2022

Cancers

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“…Next issue worth considering is new type of transmural stents- electrocautery-tip LAMSs (EC-LAMSs)—which allows single-step EUS-guided drainage of pancreatic fluid collections 30 , 31 . This type of stent is a novel self-expanding metal stent 30 , 31 , which may be used in endotherapy of pancreatic necrosis without necessity to use other endoscopic tools during first endoscopic procedure (under performed cystogastrostomy or cystoduodenostomy) 30 , 31 . Currently two types of EC-LAMSs for various EUS-guided procedures are available: Hot-Spaxus (Taewoong Medical Co, Gimpo, Korea) and Hot-Axios (Boston Scientific, Marlborough, Mass, USA) 30 , 31 .…”

Section: Discussionmentioning

confidence: 99%

“…This type of stent is a novel self-expanding metal stent 30 , 31 , which may be used in endotherapy of pancreatic necrosis without necessity to use other endoscopic tools during first endoscopic procedure (under performed cystogastrostomy or cystoduodenostomy) 30 , 31 . Currently two types of EC-LAMSs for various EUS-guided procedures are available: Hot-Spaxus (Taewoong Medical Co, Gimpo, Korea) and Hot-Axios (Boston Scientific, Marlborough, Mass, USA) 30 , 31 . In recently published article concerning EC-LAMSs, it has been proved, that novel EC-LAMS has high technical and clinical success rates for various interventional EUS indications, also for procedures of endoscopic transmural drainage of post-inflammatory pancreatic and peripancreatic fluid collections 31 .…”

Section: Discussionmentioning

confidence: 99%

“…Currently two types of EC-LAMSs for various EUS-guided procedures are available: Hot-Spaxus (Taewoong Medical Co, Gimpo, Korea) and Hot-Axios (Boston Scientific, Marlborough, Mass, USA) 30 , 31 . In recently published article concerning EC-LAMSs, it has been proved, that novel EC-LAMS has high technical and clinical success rates for various interventional EUS indications, also for procedures of endoscopic transmural drainage of post-inflammatory pancreatic and peripancreatic fluid collections 31 . EC-LAMSs were not used in our study.…”

Section: Discussionmentioning

confidence: 99%

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Early endoscopic treatment of symptomatic pancreatic necrotic collections

Jagielski

Piątkowski

Jackowski

2022

Sci Rep

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EUS-guided transmural endoscopic drainage is commonly used in the treatment of WOPN in the late phase of ANP. The role of endoscopic intervention remains unclear in the early phase of ANP. This study aimed to prospectively evaluate early endoscopic treatment of ANCs compared with endoscopic drainage of WOPN. Overall, 71 patients with ANP who underwent transmural endoscopic drainage for necrotic collections were included. Endoscopic intervention was performed within the first four weeks of ANP in 25 (35.21%) patients with ANC (Group 1) and in 46 (64.79%) patients after four weeks since the onset of ANP with WOPN (Group 2). The overall mean age of patients was 49.9 (22–79) years and 59 of them were males. The mean time of active drainage and duration of total endoscopic treatment was 26.8 and 16.9 days (P = 0.0001) and 270.8 and 164.2 days (P = 0.0001) in Groups 1 and 2, respectively. The average total number of endoscopic interventions was 9.5 and 4.5 in Groups 1 and 2, respectively (P = 0.0001). The clinical success rate, frequency of complications of endoscopic interventions, long-term success rate, and recurrence rate were not significantly different between the groups (P > 0.05 for each). Transmural endoscopic drainage is effective method of treatment of early ANCs within the first four weeks of ANP. However, compared with endoscopic intervention in WOPN, more interventions and longer duration of drainage are required.

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“…Raiter et al reported a case of ASC that was successfully treated with EUS-GBD and used cholecystoscopy through a lumen of the previously implanted lumen-apposing metal stent (LAMS) to treat the cholelithiasis [ 17 ]. Mangiavillano et al also reported clinical success was achieved in treating AC patients with EUS-guided LAMS [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study

Chen

Xie

Chen³

et al. 2022

BMC Gastroenterol

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Purposes In this study, we aimed to identify the distribution of presenting laboratory and nonenhanced computed tomography (CT) imaging features within 48 h before percutaneous cholecystostomy (PC) and create a model to appropriately guide the diagnosis of acute suppurative cholecystitis (ASC). Methods The study population included 204 acute cholecystitis patients who underwent PC. Based on the timing of the last laboratory and CT examinations before PC, the patients were divided into two groups: within 48 h before PC (Group 1, n = 138) and over 48 h before PC (Group 2, n = 63). The clinical features of the ASC patients in the two groups were compared. A multivariable model for the diagnosis of ASC in the patients in Group 1 was developed. Results Thirty-nine patients in Group 1 had ASC (28.3%). Gallbladder stones, common bile duct stones, gallbladder wall thickness > 2.85 mm, and neutrophil granulocytes > 82.55% were confirmed to be independent risk factors for ASC. The receiver operating characteristic curve of the recurrence prediction model verified its accuracy (area under the curve: 0.803). Compared with the ASC patients in Group 2, the ASC patients in Group 1 had a higher proportion of pericholecystic exudation or fluid (P = 0.013) and thicker gallbladder walls (P = 0.033). Conclusions Using nonenhanced CT imaging features and cutoffs for neutrophil granulocytes, we were able to identify a simple algorithm to discriminate ASC. The degree of local inflammation of the gallbladder in ASC patients progressively increases over time, and these changes can be observed on nonenhanced CT images. However, the symptoms of abdominal pain are of little help in estimating the disease duration in elderly patients.

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Safety and efficacy of a novel electrocautery-enhanced lumen-apposing metal stent in interventional EUS procedures (with video)

Cited by 56 publications

References 20 publications

Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis

Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis

Early endoscopic treatment of symptomatic pancreatic necrotic collections

Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study

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