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Lumen‐apposing metal stents for endoscopic ultrasonography‐guided interventions
Author(s) -
Bang Ji Young,
Varadarajulu Shyam
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13428
Subject(s) - medicine , psychological intervention , stent , endoscopic ultrasound , adverse effect , lumen (anatomy) , perforation , therapeutic endoscopy , surgery , general surgery , intensive care medicine , radiology , endoscopy , materials science , psychiatry , punching , metallurgy
Lumen‐apposing metal stents ( LAMS ) are integrated in a single‐step delivery platform and can be deployed under endoscopic ultrasound‐guidance for the drainage of intra‐abdominal fluid collections, decompression of obstructed ductal systems, establishment of anastomosis or creation of fistulous tracts between organs that can facilitate further endoscopic interventions if required. A unique feature of LAMS is their ability to approximate the adjoining structures, thereby minimizing the potential for leak and perforation. Consequently, the innovation has advanced our ability to carry out complex therapeutic interventions and obviate the need for high‐risk surgical procedures, particularly in morbid patients. However, a keen awareness of the technical design of LAMS and its implication on treatment effect is important to minimize adverse events and to improve clinical outcomes. This review outlines the technical approach to placement of LAMS , procedural challenges, adverse events, current clinical indications and emerging applications.