A newly designed fully covered metal stent for lumen apposition in EUS-guided drainage and access: a feasibility study (with videos)
- Authors
- Moon, Jong Ho; Choi, Hyun Jong; Kim, Dong Choon; Lee, Yun Nah; Kim, Hee Kyung; Jeong, Song Ah; Lee, Tae Hoon; Cha, Sang-Woo; Cho, Young Deok; Park, Sang Heum; Jeong, Seok; Lee, Don Haeng; Isayama, Hiroyuki; Itoi, Takao
- Issue Date
- Jun-2014
- Publisher
- Mosby Inc.
- Keywords
- Feasibility study
- Citation
- Gastrointestinal Endoscopy, v.79, no.6, pp 990 - 995
- Pages
- 6
- Journal Title
- Gastrointestinal Endoscopy
- Volume
- 79
- Number
- 6
- Start Page
- 990
- End Page
- 995
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/12160
- DOI
- 10.1016/j.gie.2014.02.015
- ISSN
- 0016-5107
1097-6779
- Abstract
- Background: A lumen-apposing stent can be used effectively under endosonographic guidance. Objective: To evaluate a newly designed, fully covered self-expandable metal stent with folding anchoring flanges for lumen apposition assembled on a conventional delivery system. Design: Retrospective case series and animal study. Setting: Tertiary care academic medical centers. Subjects: Six pigs for animal study and 7 patients, 3 of whom underwent endoscopic drainage for acute cholecystitis (AC) and 4 for pancreatic fluid collection (PFC). Intervention: Stent deployment under EUS guidance after puncturing, passage of an endoscope through the stent into the gallbladder (GB), or PFC with conventional endoscopic procedures. Main Outcome Measurements: Technical and clinical success, adverse events, and removability. Results: In the animal study, the stent was successfully inserted and deployed in the GB via a transgastric approach under EUS guidance without adverse events in all 6 pigs. Contrast injection demonstrated the absence of leakage. Cholecystoscopy with enhanced endoscopy was performed successfully in all animals after stent placement. All stents were intact and were removed successfully at 4 weeks. GB firmly adhered to the stomach with an intact cholecystogastric tract on necropsy and histopathology. The stents were successfully deployed without adverse effects in 7 patients. AC or PFC was resolved after stent placement in all patients. Endoscopic procedures were possible through the stent. Stent migration was not observed. The stent was successfully removed from the 4 patients with PFC after complete resolution. Limitations: Small sample size, retrospective study. Conclusions: Transenteric drainage and endoscopic intervention by using a novel fully covered self-expandable metal stent for lumen apposition under EUS guidance is feasible for the management of AC and PFC. Further study is warranted.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Pathology > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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