Endoscopic ultrasound · 2025
Efficacy and safety of a fully covered self-expandable metallic stent equipped with square flare in EUS-guided drainage/anastomosis: A multicenter retrospective study.
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Takahashi Sho, Matsubara Saburo, Fujisawa Toshio, Otsuka Takeshi, Suda Kentaro, Ushio Mako, Fukuma Taito, Suzuki Akinori, Takasaki Yusuke, Ito Koichi, Tomishima Ko, Ishii Shigeto, Nagoshi Sumiko, Isayama Hiroyuki
Аннотация
BACKGROUND AND OBJECTIVES: Recent technological advances in interventional EUS have improved EUS-guided drainage/anastomosis (EUS-D/A), yet challenges remain. This study evaluated the safety and feasibility of a square flare fully covered self-expandable metallic stent (SF-FCSEMS) with anti-migration properties for EUS-D/A.
METHODS: This retrospective cohort study was performed at 2 academic centers and analyzed patients who underwent SF-FCSEMS placement for EUS-D/A from April 2015 to November 2022. We have used an SF-FCSEMS that has a square flare at both ends that is 4 mm larger in diameter than the stent body, providing an anti-migration effect.
RESULTS: Thirty-six patients (median age: 74 years), 41.6% male, were included. Malignancies accounted for 83.3%. Among the EUS-D/A procedure types, EUS-abscess drainage was performed in 52.8%, EUS-guided gallbladder drainage in 30.6%, and EUS-guided abscess drainage in 16.7%. The technical success rate was 97.2%, and the clinical success rate was 97.1%. The median procedure time was 36 minutes, with puncture tract dilation conducted in all cases. Adverse events occurred in 11.1%; recurrent symptoms were observed in 11.8%, with no migration. SF-FCSEMS removal was performed in 26.5% of patients during the follow-up period, with a median duration of 154 days. The total cost of deploying SF-FCSEMS was approximately 40% less than that of using lumen apposing metal stent.
CONCLUSIONS: EUS-D/A with an SF-FCSEMS, which has anti-migration properties, not only was effective and feasible in the present study but also demonstrated a cost advantage.
METHODS: This retrospective cohort study was performed at 2 academic centers and analyzed patients who underwent SF-FCSEMS placement for EUS-D/A from April 2015 to November 2022. We have used an SF-FCSEMS that has a square flare at both ends that is 4 mm larger in diameter than the stent body, providing an anti-migration effect.
RESULTS: Thirty-six patients (median age: 74 years), 41.6% male, were included. Malignancies accounted for 83.3%. Among the EUS-D/A procedure types, EUS-abscess drainage was performed in 52.8%, EUS-guided gallbladder drainage in 30.6%, and EUS-guided abscess drainage in 16.7%. The technical success rate was 97.2%, and the clinical success rate was 97.1%. The median procedure time was 36 minutes, with puncture tract dilation conducted in all cases. Adverse events occurred in 11.1%; recurrent symptoms were observed in 11.8%, with no migration. SF-FCSEMS removal was performed in 26.5% of patients during the follow-up period, with a median duration of 154 days. The total cost of deploying SF-FCSEMS was approximately 40% less than that of using lumen apposing metal stent.
CONCLUSIONS: EUS-D/A with an SF-FCSEMS, which has anti-migration properties, not only was effective and feasible in the present study but also demonstrated a cost advantage.