title: Endoscopic ultrasound-guided placement of AXIOS stent for drainage of pancreatic fluid collections.
abstract: Pancreatic fluid collections (PFCs) have conventionally been treated with surgery, percutaneous drainage, or with the more recently established endoscopic ultrasound (EUS)-guided drainage modality. Currently, endoscopic plastic or metallic stents are used for PFC drainage. Plastic stents present issues with stent migration and premature occlusion requiring frequent stent exchanges or placement of additional stents. Metallic stents are tubular and may migrate, resulting in inefficient drainage, content leakage, retrieval and replacement, and possible mucosal injury. The aim of this review was to summarize and evaluate the clinical and technical effectiveness of EUS-guided placement of the recently developed AXIOS stent, a lumen-apposing self-expandable metallic stent (LASEMS)for PFC drainage. A literature review was performed to identify the studies describing this technique. In this review article we have summarized case series or reports describing EUS-guided LASEMS placement. The indications, techniques, limitations and complications reported are discussed. A total of 298 patients were included across all studies described thus far in the literature. Overall, a 97% technical success rate and a 96% clinical success rate have been reported. Early and late complications related to the placement or removal of LASEMS have been reported, however few cases have presented life-threatening results. EUS-guided PFC drainage and LASEMS placement can be a safe and effective alternative approach in the management of selected patients.
authors.affiliation: Department of Internal Medicine, Mount Sinai Health Systems, New York (Rashmee Patil), USA.
authors.forename: Rashmee
authors.initials: R
authors.lastname: Patil
authors.affiliation: Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, New York (Mel A. Ona, Sury Anand, Sushil Duddempudi), USA.
authors.forename: Mel A
authors.initials: MA
authors.lastname: Ona
authors.affiliation: Department of Advanced Therapeutic Endoscopy, MD Anderson Cancer Center, Academic and Clinical Affiliate of the University of Texas, Houston (Charilaos Papafragkakis), USA.
authors.forename: Charilaos
authors.initials: C
authors.lastname: Papafragkakis
authors.affiliation: Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, New York (Mel A. Ona, Sury Anand, Sushil Duddempudi), USA.
authors.forename: Sury
authors.initials: S
authors.lastname: Anand
authors.affiliation: Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, New York (Mel A. Ona, Sury Anand, Sushil Duddempudi), USA.
authors.forename: Sushil
authors.initials: S
authors.lastname: Duddempudi
keywords: AXIOS; Endoscopic ultrasound; drainage; lumen-apposing stent; pancreatic fluid collection