Endoscopy 2022; 54(S 01): S85-S86
DOI: 10.1055/s-0042-1744764
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
08:30–09:30 Saturday, 30 April 2022 Club A. Optimizing EUS guided interventions

SAFETY AND FEASIBILITY OF LUMEN-APOSSING METAL STENTS REMOVALS. RESULTS FROM A PROSPECTIVE NATIONWIDE REGISTRY

S. Bazaga
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
F.J. Garcia-Alonso
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
J.R. Aparicio Tormo
2   Hospital General Universitario de Alicante, Alicante, Spain
,
B. Martinez Moreno
2   Hospital General Universitario de Alicante, Alicante, Spain
,
V. Sanchiz
3   Hospital Clínico Universitario de Valencia, Valencia, Spain
,
C. Suria
3   Hospital Clínico Universitario de Valencia, Valencia, Spain
,
A. Garcia-Sumalla
4   Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
,
J.B Gornals
4   Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
,
C. Loras
5   Hospital Universitari Mútua de Terrassa, Terrassa, Spain
,
C. Chavarría
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
F.J. García-Fernandez
6   Hospital Universitario Virgen del Rocío, Sevilla, Spain
,
Á. Terán
7   Hospital Universitario Marqués de Valdecilla, Santander, Spain
,
E. Vazquez-Sequeiros
8   Hospital Universitario Ramón y Cajal, Madrid, Spain
,
R. Pedraza Sanz
9   Hospital General Universitario de Castellón, Castellón, Spain
,
L. Pérez-Carazo
10   Hospital General Universitario Gregorio Marañon, Madrid, Spain
,
J.C. Súbtil
11   Clínica Universidad de Navarra, Pamplona, Spain
,
A. Pérez-Millan
12   Hospital Universitario Rio Carrión, Palencia, Spain
,
F. Uceda Porta
13   Hospital General Universitario de Elche, Elche, Spain
,
V. Busto Bea
14   Complejo Hospitalario de Navarra, Pamplona, Spain
,
C. de la Serna-Higuera
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
I. Pinto García
15   Hospital Regional de Málaga, Málaga, Spain
,
J. Colán-Hernández
16   Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
C. Huertas
17   Hospital Universitari de Girona Josep Trueta, Girona, Spain
,
A. Vilella Martorell
18   Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain
,
A. Guardiola-Arévalo
19   Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
,
J.L. Castro Urda
20   Hospital Universitario Severo Ochoa, Leganés, Spain
,
J. Nuñez-Otero
21   Hospital Universitario del Sureste, Arganda del Rey, Spain
,
E. Sánchez-Hernández
22   Complejo Hospitalario Universitario de Ourense, Ourense, Spain
,
F. Gonzalez-Huix
23   Clínica de Girona, Girona, Spain
24   Hospital Universitari Arnau de Vilanova, Lleida, Spain
,
F. de la Morena
25   Hospital Universitario La Princesa, Madrid, Spain
,
R. Villanueva Pavón
26   Hospital Universitario de León, León, Spain
,
I. Couto-Worner
27   Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
C. Guarner-Argente
28   Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
,
M. Perez-Miranda
1   Hospital Universitario Rio Hortega, Valladolid, Spain
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Aims Lumen-apposing metal stents (LAMS) removals are performed in advanced endoscopy suites equipped with fluoroscopy. Studies assessing the removal complexity, technique and adverse events (AEs) are lacking.

Methods Prospective case series including all consecutive LAMS placement attempts between 2019-2020 in 31 centers. Analysis of all endoscopic removals following a technically successful LAMS placement. After removal, a centralised, standardised follow-up interview was undertaken. Complex removals were defined as those described as difficult by the endoscopist or if the time required was>90th percentile. Multivariable logistic regression techniques assessed risk factors for embedment and complex removal.

Results A total of 158 removal attempts after a median indwell time of 46.5 days (IQR: 31-70) were included ([Table 1]). Stent embedment was observed in 19 (12%) cases, partial (14 (8.9%)) or total (5 (3.2%)). An indwell time>5 weeks (3.6% vs 16.7%, p=0.02) was the only embedment risk factor.

Overall, 156 (98.7%) retrievals were successful, requiring 2 minutes (IQR: 1-4). Stent embedment associated longer removal times (p=0.001). 149 (94.3%) removals were performed by proximal flap traction (rat-tooth forceps or polypectomy snare) and 140 (88.6%) were classified as easy/very easy. We identified 13 (8.2%) complex removals. Predictors of complex removal were: stent embedment (OR: 10.4 (2.8-38.3)) and LAMS placed without a free-hands technique (OR: 5.1 (1, 2-21, 5)). We identified 7 (4.3%) AEs, all mild/moderate intraprocedural gastrointestinal bleeds.

Table 1

Age, med (IQR)

62.2 (50.8-70.5)

Sex male, n (%)

105 (66.5%)

Indication , n (%)

WON 76 (48.1%)
Pseudocysts 39 (24.7%)
No pancreatic fluid collections 19 (12%)
Enteroanastomoses 17 (10,8%)
Others 7 (4,4%)

Adhered tissue to the LAMS,n (%)

25 (15,8%)

Intact LAMS coating, n (%)

145 (91,8%)

Conclusions Removals of LAMS placed with a free-hand technique scheduled within 5 weeks after deployment can be undertaken in a conventional endoscopy suite.



Publication History

Article published online:
14 April 2022

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