Análisis retrospectivo multicéntrico de las incidencias asociadas a las prótesis de aposición luminal tipo Axios(TM) / A retrospective, multicenter analysis of incidents associated with Axios(TM) lumen-apposing stents

Introducción: existe controversia respecto a los riesgos asociados a las prótesis de aposición luminal (PAL), con importantes variaciones entre los trabajos disponibles. Objetivos: describir el tipo y la proporción de complicaciones durante la permanencia y retirada de PAL tipo Axios(TM). Describir la relación entre tiempo de permeabilidad, diana terapéutica y presencia de complicaciones. Métodos: serie de casos retrospectiva y multicéntrica que incluyó todos los pacientes consecutivos a los que se les colocó una PAL para acceder a estructuras extraluminales durante el año 2017. Se registraron únicamente aquellos casos que alcanzaron éxito técnico. Resultados: se incluyeron 179 pacientes de siete centros (rango 4-68 casos/centro) con edad media de 64,3 años (DE: 15,8, rango 24,6-98,8 años), 122 (68,2%) de ellos varones. Las indicaciones más frecuentes fueron las necrosis encapsuladas (58, 32,4%), seguidas de pseudoquistes (31, 17,3%) y drenajes vesiculares (26, 14,5%). Durante la permanencia de la PAL se documentaron complicaciones en 19 pacientes (10,9%), siendo las más frecuentes las obstrucciones de la luz protésica o del marco gastroduodenal en ocho (4,5%) casos y las hemorragias en siete (3,9%) pacientes. Las PAL no se retiraron en 86 pacientes (48%) por los siguientes motivos: intención permanente de la PAL en 46 (53,5%), pérdida del seguimiento en 18 (20,9%), fallecimiento del paciente en 16 (18,6%) y migración en seis (7%). Durante la retirada se observaron cinco complicaciones (5,4%), tres casos de hemorragia y dos perforaciones. No observamos una asociación entre el tiempo de permanencia y las complicaciones (p = 0,67). Conclusión: la aparición de complicaciones secundarias a la inserción de PAL es poco frecuente, aunque pueden ser graves. En este estudio no se ha observado una asociación entre la aparición de complicaciones y el tiempo de permanencia de la prótesis

Introduction: there is controversy with regard to the risks associated with lumen-apposing metal stents (LAMSs), with significant variations between available reports. Objectives: to describe the types and proportions of complications that arise during the permanence time and removal of Axios(TM) LAMS. Furthermore, the relationship between patency time, therapeutic target and the presence of complications was also described. Methods: a retrospective, multicenter case series study was performed of all patients with an implanted LAMS to access extra-luminal structures during 2017. Only technically successful cases were recorded. Results: a total of 179 patients from seven sites (range, 4-68 cases/site) were included in the study, with a mean age of 64.3 years (SD: 15.8; range: 24.6-98.8 years) and 122 (68.2%) were male. Most common indications included encapsulated necrosis (58, 32.4%), pseudocysts (31, 17.3%) and gallbladder drains (26, 14.5%). Complications during LAMS stay were reported in 19 patients (10.9%); stent lumen or gastroduodenal obstruction (8, 4.5%) and bleeding (7, 3.9%) were the most common. LAMS were not removed in 86 (48%) patients due to the following reasons: a permanent stent was used (46, 53.5%), loss to follow-up (18, 20.9%), patient demise (16, 18.6%) and stent migration (6, 7%). Five (5.4%) complications were reported during stent removal, which were three bleeds and two perforations. No association was found between stent duration and complications (p = 0.67). Conclusion: complications secondary to LAMS insertion are uncommon but may be serious. This study found no association between complications and stent duration

A retrospective, multicenter analysis of incidents associated with Axios™ lumen-apposing stents.

INTRODUCTION: there is controversy with regard to the risks associated with lumen-apposing metal stents (LAMSs), with significant variations between available reports. OBJECTIVES: to describe the types and proportions of complications that arise during the permanence time and removal of Axios™ LAMS. Furthermore, the relationship between patency time, therapeutic target and the presence of complications was also described. METHODS: a retrospective, multicenter case series study was performed of all patients with an implanted LAMS to access extra-luminal structures during 2017. Only technically successful cases were recorded. RESULTS: a total of 179 patients from seven sites (range, 4-68 cases/site) were included in the study, with a mean age of 64.3 years (SD: 15.8; range: 24.6-98.8 years) and 122 (68.2%) were male. Most common indications included encapsulated necrosis (58, 32.4%), pseudocysts (31, 17.3%) and gallbladder drains (26, 14.5%). Complications during LAMS stay were reported in 19 patients (10.9%); stent lumen or gastroduodenal obstruction (8, 4.5%) and bleeding (7, 3.9%) were the most common. LAMS were not removed in 86 (48%) patients due to the following reasons: a permanent stent was used (46, 53.5%), loss to follow-up (18, 20.9%), patient demise (16, 18.6%) and stent migration (6, 7%). Five (5.4%) complications were reported during stent removal, which were three bleeds and two perforations. No association was found between stent duration and complications (p = 0.67). CONCLUSION: complications secondary to LAMS insertion are uncommon but may be serious. This study found no association between complications and stent duration.