Luminal-apposing stents for benign intraluminal strictures: a large United States multicenter study of clinical outcomes
| Autor: | Vanessa M. Shami, Douglas G. Adler, Benjamin Tharian, Todd H. Baron, Moamen Gabr, Neil R. Sharma, Meir Mizrahi, Lindsey Merritt, Salman Khan, Mahmood Syed Kashif, Michael P. Croglio, Yazan Fahmawi, Ted W James, Tyler M. Berzin, Dushant S. Uppal, Manoj Kumar, Sumant Inamdar, Douglas K. Pleskow |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Placement procedures medicine.medical_treatment Subgroup analysis Lumen-apposing metal stent 03 medical and health sciences 0302 clinical medicine Refractory Stent removal immune system diseases hemic and lymphatic diseases Medicine Adverse effect stent migration business.industry Gastroenterology Stent Pylorus bacterial infections and mycoses Surgery gastrointestinal stricture medicine.anatomical_structure Multicenter study 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology lipids (amino acids peptides and proteins) Original Article business |
| Zdroj: | Annals of Gastroenterology |
| ISSN: | 1108-7471 |
| Popis: | Background The use of fully covered lumen-apposing metal stents (LAMS) for benign short gastrointestinal (GI) strictures has been reported. This study aimed to evaluate the safety and efficacy of LAMS for refractory GI strictures. Methods A retrospective analysis was performed of patients who underwent LAMS placement for benign GI strictures in 8 United States centers. The primary outcomes were technical success and initial clinical response. Secondary outcomes were reintervention rate and adverse events. Results A total of 51 patients underwent 61 LAMS placement procedures; 33 (64.7%) had failed previous treatments. The most common stricture location was the pylorus (n=17 patients). Various sizes of stents were used, with 15-mm LAMS placed in 45 procedures, 20-mm LAMS in 14 procedures, and 10-mm LAMS in 2 procedures. The overall technical success, short-term clinical response and reintervention rate after stent removal were 100%, 91.8% and 31.1%, respectively. Adverse events were reported in 17 (27.9%) procedures, with stent migration being the most common (13.1%). In subgroup analysis, both 15 mm and 20 mm stents had comparable short-term clinical response and adverse event rates. However, stent migration (15.6%) was the most common adverse event with 15-mm LAMS while pain (14.3%) was the most common with 20-mm LAMS. The reintervention rate was 80% at 200-day follow up after stent removal. Conclusions Using LAMS for treatment of short benign GI strictures is safe and effective. Larger LAMS, such as the new 20 mm in diameter, may have a lower stent migration rate compared to smaller diameter LAMS. |
| Databáze: | OpenAIRE |
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