Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications

BACKGROUND: The recently introduced Hot AXIOS™ system for endoscopic ultrasound (EUS)-guided transenteric drainage has the potential to change interventional endoscopy significantly. The aim of our study was to assess the effectiveness and safety of this new type of lumen-apposing metal stent (LAMS)...

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Autores principales: Anderloni, Andrea, Leo, Milena Di, Carrara, Silvia, Fugazza, Alessandro, Maselli, Roberta, Buda, Andrea, Amato, Arnaldo, Auriemma, Francesco, Repici, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191873/
https://www.ncbi.nlm.nih.gov/pubmed/30386125
http://dx.doi.org/10.20524/aog.2018.0299
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author Anderloni, Andrea
Leo, Milena Di
Carrara, Silvia
Fugazza, Alessandro
Maselli, Roberta
Buda, Andrea
Amato, Arnaldo
Auriemma, Francesco
Repici, Alessandro
author_facet Anderloni, Andrea
Leo, Milena Di
Carrara, Silvia
Fugazza, Alessandro
Maselli, Roberta
Buda, Andrea
Amato, Arnaldo
Auriemma, Francesco
Repici, Alessandro
author_sort Anderloni, Andrea
collection PubMed
description BACKGROUND: The recently introduced Hot AXIOS™ system for endoscopic ultrasound (EUS)-guided transenteric drainage has the potential to change interventional endoscopy significantly. The aim of our study was to assess the effectiveness and safety of this new type of lumen-apposing metal stent (LAMS) with cautery system for pancreatic collection, and gallbladder and biliary tree drainage. METHODS: We retrospectively reviewed consecutive patients undergoing EUS-guided drainage by LAMS with cautery system in a tertiary-care academic medical center between March 2014 and March 2017. All patients were included in our prospectively maintained institutional EUS database. The main outcome measures were technical success, clinical effectiveness, and adverse events. RESULTS: A total of 45 patients (20 men, mean age 69.6 years) underwent LAMS placement. Indications were pancreatic fluid collections (19 patients, 42.2%), acute cholecystitis (10 patients, 22.2%), and biliary drainage (16 patients, 35.5%). Technical success was achieved in all patients except one (97.7%). Clinical success was achieved in 86.4% (38/44) of cases and adverse events occurred in 5 (11.4%) of patients. CONCLUSIONS: In our experience, EUS-guided LAMS placement performed by expert endoscopists was feasible and effective in the endoscopic management of pancreatic fluid collection, and biliary and gallbladder drainage. Optimization of transmural drainage by new dedicated devices could improve efficacy and safety in appropriately selected patients.
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spelling pubmed-61918732018-11-01 Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications Anderloni, Andrea Leo, Milena Di Carrara, Silvia Fugazza, Alessandro Maselli, Roberta Buda, Andrea Amato, Arnaldo Auriemma, Francesco Repici, Alessandro Ann Gastroenterol Original Article BACKGROUND: The recently introduced Hot AXIOS™ system for endoscopic ultrasound (EUS)-guided transenteric drainage has the potential to change interventional endoscopy significantly. The aim of our study was to assess the effectiveness and safety of this new type of lumen-apposing metal stent (LAMS) with cautery system for pancreatic collection, and gallbladder and biliary tree drainage. METHODS: We retrospectively reviewed consecutive patients undergoing EUS-guided drainage by LAMS with cautery system in a tertiary-care academic medical center between March 2014 and March 2017. All patients were included in our prospectively maintained institutional EUS database. The main outcome measures were technical success, clinical effectiveness, and adverse events. RESULTS: A total of 45 patients (20 men, mean age 69.6 years) underwent LAMS placement. Indications were pancreatic fluid collections (19 patients, 42.2%), acute cholecystitis (10 patients, 22.2%), and biliary drainage (16 patients, 35.5%). Technical success was achieved in all patients except one (97.7%). Clinical success was achieved in 86.4% (38/44) of cases and adverse events occurred in 5 (11.4%) of patients. CONCLUSIONS: In our experience, EUS-guided LAMS placement performed by expert endoscopists was feasible and effective in the endoscopic management of pancreatic fluid collection, and biliary and gallbladder drainage. Optimization of transmural drainage by new dedicated devices could improve efficacy and safety in appropriately selected patients. Hellenic Society of Gastroenterology 2018 2018-07-26 /pmc/articles/PMC6191873/ /pubmed/30386125 http://dx.doi.org/10.20524/aog.2018.0299 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Anderloni, Andrea
Leo, Milena Di
Carrara, Silvia
Fugazza, Alessandro
Maselli, Roberta
Buda, Andrea
Amato, Arnaldo
Auriemma, Francesco
Repici, Alessandro
Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title_full Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title_fullStr Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title_full_unstemmed Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title_short Endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
title_sort endoscopic ultrasound-guided transmural drainage by cautery-tipped lumen-apposing metal stent: exploring the possible indications
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191873/
https://www.ncbi.nlm.nih.gov/pubmed/30386125
http://dx.doi.org/10.20524/aog.2018.0299
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