Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience

<b>Background and study aims</b> Although outcomes of lumen-apposing metal stents (LAMS) placement in native anatomy have been reported, data on LAMS placement in surgically altered anatomy (SAA) are sparse. We aimed to assess outcomes of LAMS placement in patients with SAA for different indications. <b>Patients and methods</b> This was an international, multicenter, retrospective, observational study at 25 tertiary care centers through November 2023. Consecutive patients with SAA who underwent LAMS placement were included. The primary outcome was technical success defined as correct placement of LAMS. Secondary outcomes were clinical success and safety. <b>Results</b> Two hundred and seventy patients (125 males; average age 61 ± 15 years) underwent LAMS placement with SAA. Procedures included EUS-directed transgastric ERCP (EDGE) and EUS-directed transenteric ERCP (EDEE) (n = 82), EUS-guided entero-enterostomy (n = 81), EUS-guided biliary drainage (n = 57), EUS-guided drainage of peri-pancreatic fluid collections (n = 48), and EUS-guided pancreaticogastrostomy (n = 2). Most cases utilized AXIOS stents (n = 255) compared with SPAXUS stents (n = 15). Overall, technical success was 98%, clinical success was 97%, and the adverse event (AE) rate was 12%. Using AGREE classification, five events were rated as Grade II, 21 events as Grade IIIa, and six events as IIIb. No difference in AEs were noted among stent types ( <i>P</i> = 0.52). <b>Conclusions</b> This study shows that placement of LAMS is associated with high technical and clinical success rates in patients with SAA. However, the rate of AEs is noteworthy, and thus, these procedures should be performed by expert endoscopists at tertiary centers.

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Journal
Endoscopy International Open
Published
2024-09-09
DOI
https://doi.org/10.1055/a-2411-1814
Citations
5
Primary Topic
Aortic aneurysm repair treatments
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article
Field-Weighted Citation Impact
2.09
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article

Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience

Michele Amata, Martha Arevalo-Mora, Doménico Galasso, Jahnvi Dhar et al.
5 citations
Endoscopy International Open
Aortic aneurysm repair treatments
2.09
article

Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience

Michele Amata, Martha Arevalo-Mora, Doménico Galasso, Jahnvi Dhar, Stefano Francesco Crinò, Amaninder J. Dhaliwal, Massimiliano Mutignani, Serena Stigliano, Antonio Facciorusso, Cesare Hassan, Alessandro Fugazza, Hyun Dong Ji, Cecilia Binda, Carmelo Barbera, Pierre H. Deprez, Andrew Ofosu, Luca De Luca, Abdul Kouanda, Avik Sarkar, Jorge Vargas‐Madrigal, Roberto Di Mitri, Michel Kahaleh, Khanh Do-Cong Pham, Danilo Paduano, Daryl Ramai, Alberto Larghi, Carmine Gentile, Jayanta Samanta, Haroon Shahid, Christopher Ko, Giuseppe Vanella, Pietro Fusaroli, Benedetto Mangiavillano, Carlos Robles‐Medranda, Van der Merwe, Paolo Giorgio Arcidiacono, Federica Calabrese, Andrea Lisotti, Michiel J. Bronswijk, Gianenrico Rizzatti, Amy Tyberg, Irene Cottone, Alessandro Repici, Roberto Leone, Francesco Maria Di Matteo, Juan Alcivar Vasquez, Francesco Auriemma, Carlo Fabbri, Abed Al‐Lehibi, John Morris, Sun‐Chuan Dai, E. Forti
article en
5 citations

Abstract

<b>Background and study aims</b> Although outcomes of lumen-apposing metal stents (LAMS) placement in native anatomy have been reported, data on LAMS placement in surgically altered anatomy (SAA) are sparse. We aimed to assess outcomes of LAMS placement in patients with SAA for different indications. <b>Patients and methods</b> This was an international, multicenter, retrospective, observational study at 25 tertiary care centers through November 2023. Consecutive patients with SAA who underwent LAMS placement were included. The primary outcome was technical success defined as correct placement of LAMS. Secondary outcomes were clinical success and safety. <b>Results</b> Two hundred and seventy patients (125 males; average age 61 ± 15 years) underwent LAMS placement with SAA. Procedures included EUS-directed transgastric ERCP (EDGE) and EUS-directed transenteric ERCP (EDEE) (n = 82), EUS-guided entero-enterostomy (n = 81), EUS-guided biliary drainage (n = 57), EUS-guided drainage of peri-pancreatic fluid collections (n = 48), and EUS-guided pancreaticogastrostomy (n = 2). Most cases utilized AXIOS stents (n = 255) compared with SPAXUS stents (n = 15). Overall, technical success was 98%, clinical success was 97%, and the adverse event (AE) rate was 12%. Using AGREE classification, five events were rated as Grade II, 21 events as Grade IIIa, and six events as IIIb. No difference in AEs were noted among stent types ( <i>P</i> = 0.52). <b>Conclusions</b> This study shows that placement of LAMS is associated with high technical and clinical success rates in patients with SAA. However, the rate of AEs is noteworthy, and thus, these procedures should be performed by expert endoscopists at tertiary centers.

Endoscopy International OpenVol. 12(10)
Università Cattolica del Sacro Cuore (IT), University of Foggia (IT), University of Verona (IT), Brooklyn Hospital Center (US), Cliniques Universitaires Saint-Luc (BE), Humanitas University (IT), Vita-Salute San Raffaele University (IT), Università Campus Bio-Medico (IT), University of California, San Francisco (US), University of Utah (US), Haukeland University Hospital (NO), King Fahd Medical City (SA), Agostino Gemelli University Polyclinic (IT), Azienda Unita' Sanitaria Locale Di Modena (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Azienda Unità Sanitaria Locale Della Romagna (IT), University of California San Francisco Medical Center (US), Ospedale “M. Bufalini” di Cesena (IT), Ospedali Riuniti Marche Nord (IT), Ospedale G.B. Morgagni - L.Pierantoni (IT), Humanitas Mater Domini (IT), Campus Bio Medico University Hospital (IT), Hôpital Riviera-Chablais (CH), Hackensack Meridian Health (US), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Instituto Ecuatoriano de Enfermedades Digestivas (EC), Kennedy Clinic Hospital (EC), IRCCS Humanitas Research Hospital (IT), Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT), University of Bergen (NO), Post Graduate Institute of Medical Education and Research (IN), Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IT), University of Nebraska Medical Center (US), University of Pretoria (ZA), University of Bologna (IT), KU Leuven (BE)
Openalex Percentile: Top 12%
Aortic aneurysm repair treatments
2.09
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