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.
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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.
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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


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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


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