Minerva Gastroenterology 2021 Apr 19

DOI: 10.23736/S2724-5985.21.02862-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Safety issues in endoscopy ultrasound-guided interventions using lumen apposing metal stents: a review of the literature

Francesco AURIEMMA ¹, Alessandro FUGAZZA ^{2, 3}, Matteo COLOMBO ^{2, 3}, Marco SPADACCINI ^{2, 3}, Alessandro REPICI ^{2, 3}, Andrea ANDERLONI ^{2, 3} ✉

¹ Digestive Endoscopy Unit, Humanitas Mater Domini, Castellanza, Varese, Italy; ² Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; ³ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

Lumen-apposing metal stents (LAMS) are recently introduced devices that allow to create anastomoses. The indications for LAMS placement are increasing and currently these stents can be used in multiple clinical situations such as endoscopic drainage of pancreatic fluid collections (PFCs), endoscopic ultrasound-guided choledocho-duodenostomy (EUS-CDS), endoscopic ultrasound gallbladder drainage (EUS-GBD), endoscopic ultrasound gastrojejunostomy (EUS-GJ). Since their introduction, they have revealed to allow a higher rate of technical and clinical success, and potentially lower risk of adverse events (AEs) compared with previously available devices. Despite ongoing innovation, any advanced intervention carries risks of AEs. These AEs may occur during the deployment or can be delayed because of the consequent effects of the procedure and/or stent itself. This review represents an overview of current indications, technical and clinical results, with an extensive focus on safety issues related to placement and on long-term indwelling related ones.

KEY WORDS: EUS-GBD; EUS-BD; EUS drainage; LAMS; Safety; Adverse events