CONTRAST MEDIUM INJECTION THROUGH HOT-AXIOS STENT: SMALL TRICK, GREAT SAFETY FOR ENDOSCOPIC ULTRASOUND-GUIDED GASTROENTEROSTOMY (PRELIMINARY RESULTS)

Aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a promising technique for management of gastric outlet obstruction. One of the major challenges regarding this technique is the loss of sonographic visualization when puncturing the gastric and intestinal wall with the electrocautery tip of the Hot-AXIOS-stent. This leads to increased risk of stent misdeployment and thus to complications like peritonitis. Injection of contrast medium through the wire-channel of the stent under fluoroscopic guidance can confirm correct positioning of the stent in the small intestine after the puncture and before it is deployed. The aim of this study was to assess the feasibility and efficacy of the technique.

Methods The data of all subjects who underwent EUS-GE with injection of contrast medium were retrospectively collected and analyzed. Stent deployment was only executed after fluoroscopic confirmation of the correct position of the stent. The primary endpoint was to assess the technical success of this technique, secondary endpoint to assess the clinical success.

Results A total of 32 patients were included in this study so far. In all procedures the injection of contrast medium through the stent and hence fluoroscopic position control was possible. The technical success rate was 100% (n=32). Clinical success was achieved in 90,6% (n=29). No major or minor complications were encountered during this study.

Fig. 1

Conclusions Injection of contrast medium through the Hot-AXIOS stent after the puncture to confirm the correct position before deployment is a new and simple technique, making EUS-GE more effective and safe.

Publication History

Article published online:
14 April 2022