Endoscopy 2020; 52(S 01): S122-S123
DOI: 10.1055/s-0040-1704378
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 11:00 – 13:00 EUS- guided therapy: From training to complications Liffey Meeting Room 3
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LUMEN APPOSING METAL STENTS RELATED ADVERSE EVENTS. RESULTS FROM A NATIONWIDE PROSPECTIVE REGISTRY

S Bazaga
1   Hospital Universitario Rio Hortega, Endoscopy, Valladolid, Spain
2   Hospital Universitari Arnau de Vilanova, Lleida, Spain
,
JR Aparicio
3   Hospital General Universitario de Alicante, Alicante, Spain
,
V Sanchiz
4   Hospital Clínic Universitari de Valencia, Valencia, Spain
,
J Gornals
5   Hospital Universitari de Bellvitge, Barcelona, Spain
,
C Loras
6   Hospital Universitari Mutua de Terrassa, Terrasa, Spain
,
R Pedraza
7   Hospital General Universitari de Castellon, Castellón, Spain
,
A Terán
8   Hospital Universitario Marques de Valdecilla, Santander, Spain
,
E Vazquez-Sequeiros
9   Hospital Ramón y Cajal, Madrid, Spain
,
J Vila
10   Complejo Hospitalario de Navarra, Pamplona, Spain
,
A Guardiola
11   Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
,
C Guarner
12   Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
,
C Huertas
13   Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
,
F Garcia-Fernandez
14   Hospital Virgen del Rocio, Sevilla, Spain
,
B Bernad
15   Hospital Universitario de Burgos, Burgos, Spain
,
A Perez
16   Hospital Río Carrión, Palencia, Spain
,
R Villanueva
17   Hospital Universitario de León, León, Spain
,
F Gonzalez-Huix
2   Hospital Universitari Arnau de Vilanova, Lleida, Spain
,
I Pinto
18   Hospital Regional Universitario de Málaga, Malaga, Spain
,
A Vilella
19   Hospital Son Llatzer, Palma de Mallorca, Spain
,
JL Castro
20   Hospital Severo Ochoa, Leganés, Spain
,
J Colán
21   Hospital Germans Trias i Pujol, Badalon, Spain
,
J Nuñez-Otero
22   Hospital Universitario del Suereste, Arganda del Rey, Spain
,
JC Subtil
23   Clínica Universidad de Navarra, Pamplona, Spain
,
L Pérez-Carazo
24   Hospital Gregorio Marañón, Madrid, Spain
,
I Couto
25   Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
E Sanchez
26   Complejo Hospitalario Universitario de Ourense, Ourense, Spain
,
F Uceda
27   Hospital General Universitario de Elche, Elche, Spain
,
B Martinez
28   Hospital Universitario del Vinalopó, Elche, Spain
,
FJ Garcia-Alonso
29   Hospital Universitario Rio Hortega, Valladolid, Spain
,
C de la Serna
29   Hospital Universitario Rio Hortega, Valladolid, Spain
,
M Perez-Miranda
29   Hospital Universitario Rio Hortega, Valladolid, Spain
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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    Aims Describe the number, type and severity of adverse events associated to lumen-apposing metal stents (LAMS) in a real-life setting.

    Tab. 1

    Indications

    Enteroanastomosis,n(%)

    70(24.7%)

    WON,n(%)

    69(24.5%)

    Gallbladder drainage,n(%)

    52(18.4%)

    Pseudocysts, n(%)

    36(12.7%)

    Others,n(%)

    56(20%)

    Methods Multicenter prospective case series including all consecutive LAMS placed to access extraluminal structures between January-October 2019. Centralized follow-up was performed via standardized telephonic questionnaires, at 14 days and 3,6,9 and 12 months after placement or until LAMS removal. In case of positive or missing responses to the questionnaire, a query was raised to the local investigators, whose reports were evaluated by a commission for categorize event.

    Results A total of 283 procedures performed in 258 patients, median age: 69 years (IQR:59-82), 63% males from 27 centers, were included. Technical success was reached in 96%. Stent placement indications are summarized in [Table 1].

    After a median follow-up of 71 (IRC:28-93) days, 128 (45.2%) stents retrieved, 52 patients (18.4%) died and 103 (36.4%) had their stent still in-situ. 62 LAMS related events were identified in 56 procedures (19.8%), 22 mild, 21 moderate, 16 severe and 3 deaths (digestive haemorrhage in walled-off-necrosis(WON) and 2 perforations, gastrojejunostomy and choledochoduodenostomy). Most frequent complications were haemorrhages (17 cases) and LAMs obstruction related infections (16 cases). Cumulative risk of LAMS related adverse events 3 months after deployment was 21.2%(16,5-27,2%), while the cumulative risk of severe/fatal events was 7.3%(4.6-11.4%). Overall, 3-month cumulative risks were higher in WONs, 31.3%(20.1-46.5%), and pseudocysts, 37.8%(21-61.5%), than in gallbladder drainages 6.2%(20.3-18.1%) or enteral anastomoses 18.6%(10.8-30.7%).

    Conclusions Our study shows an acceptable overall risks rate, although the 3 (0.9%) LAMS related deaths require further analysis of risk factors.


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