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Lumen-apposing metal stents for the treatment of pancreatic and peripancreatic fluid collections and bleeding risk: a propensity matched study.
Mangiavillano, Benedetto; Lakhtakia, Sundeep; Samanta, Jayanta; Auriemma, Francesco; Vargas-Madrigal, Jorge; Arcidiacono, Paolo Giorgio; Barbera, Carmelo; Ashhab, Hazem; Song, Tae Jun; Pham, Khanh Do-Kong; Teoh, Anthony Y B; Moon, Jong Ho; Crinò, Stefano Francesco; Kongkam, Pradermchai; Aragona, Giovanni; De Lusong, Mark A; Dhar, Jahnvi; Ofosu, Andrew; Ventra, Agostino; Paduano, Danilo; Franchellucci, Gianluca; Repici, Alessandro; Larghi, Alberto; Facciorusso, Antonio.
Afiliación
  • Mangiavillano B; Gastrointestinal Endoscopy, Humanitas Mater Domini, Castellanza, Italy.
  • Lakhtakia S; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
  • Samanta J; Gastroenterology, AJG Hospitals, Gachibowli, Hyderabad, India.
  • Auriemma F; Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
  • Vargas-Madrigal J; Gastrointestinal Endoscopy, Humanitas Mater Domini, Castellanza, Italy.
  • Arcidiacono PG; Gastroenterology Department, Enrique Baltodano Briceno Hospital, Liberia, Costa Rica.
  • Barbera C; Pancreatobiliary Endoscopy and Endosonography Division, Istituto Scientifico Universitario San Raffaele, Milano, Italy.
  • Ashhab H; Gastroenterology Unit, Civil Hospital Giuseppe Mazzini, Teramo, Italy.
  • Song TJ; Gastroenterology, Ahli Hospital, Hebron, Palestine, State of.
  • Pham KD; Gastroenterology, Asan Medical Center, Songpa-gu, Korea (the Republic of).
  • Teoh AYB; Bergen Research group for Gastrointestinal Endoscopy (BRAGE), Department of Medicine, Haukeland University Hospital, Bergen, Norway.
  • Moon JH; Division of Upper Gastrointestinal and Metabolic Surgery, Prince of Wales Hospital, Hong Kong, Hong Kong.
  • Crinò SF; Internal Medicine, Soon Chung Hyang University School of Medicine, Bucheon, Korea (the Republic of).
  • Kongkam P; Gastroenterology, University of Verona, Verona, Italy.
  • Aragona G; Division of Hospital and Ambulatory Medicine, and Pancreas Research Unit, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
  • De Lusong MA; Internal Medicine, Gastroenterology and Hepatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy.
  • Dhar J; Interventional Endoscopy, University of the Philippines Manila, Manila, Philippines.
  • Ofosu A; Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
  • Ventra A; Division of Digestive Diseases, University of Cincinnati, Cincinnati, United States.
  • Paduano D; Gastroenterology, Azienda Ospedaliera Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
  • Franchellucci G; Gastrointestinal Endoscopy, Humanitas Mater Domini, Castellanza, Italy.
  • Repici A; Endoscopy Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
  • Larghi A; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
  • Facciorusso A; Endoscopy Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
Endoscopy ; 56(4): 249-257, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38237633
ABSTRACT

INTRODUCTION:

Endoscopic ultrasound (EUS)-guided drainage of symptomatic pancreatic fluid collections (PFCs) using the Hot-Axios device has recently been associated with a significant risk of bleeding. This adverse event (AE) seems to occur less frequently with the use of a different device, the Spaxus stent. The aim of the current study was to compare the rates of bleeding between the two stents.

METHODS:

Patients admitted for treatment of PFCs by EUS plus lumen-apposing metal stent in 18 endoscopy referral centers between 10 July 2019 and 28 February 2022 were identified and their outcomes compared using a propensity-matching analysis.

RESULTS:

363 patients were evaluated. After a 1-to-1 propensity score match, 264 patients were selected (132 per group). The technical and clinical success rates were comparable between the two groups. Significantly more bleeding requiring transfusion and/or intervention occurred in the Hot-Axios group than in the Spaxus group (6.8% vs. 1.5%; P = 0.03); stent type was a significant predictor of bleeding in both univariate and multivariate regression analyses (P = 0.03 and 0.04, respectively). Bleeding necessitating arterial embolization did not however differ significantly between the two groups (3.0% vs. 0%; P = 0.12). In addition, the Hot-Axios was associated with a significantly higher rate of overall AEs compared with the Spaxus stent (9.8% vs. 3.0%; P = 0.04).

CONCLUSION:

Our study showed that, in patients with PFCs, bleeding requiring transfusion and/or intervention occurred significantly more frequently with use of the Hot-Axios stent than with the Spaxus stent, although this was not the case for bleeding requiring embolization.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Páncreas / Enfermedades Pancreáticas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Endoscopy Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Páncreas / Enfermedades Pancreáticas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Endoscopy Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania