Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy?
Abstract Objectives This study aimed to characterize the clinical outcomes, safety, and efficacy of lumen‐apposing metal stents (LAMS) in treating benign gastrointestinal strictures. Methods A single‐center retrospective review of all patients who underwent LAMS placement for benign strictures from...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-04-01
|
| Series: | DEN Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/deo2.70005 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849713921037959168 |
|---|---|
| author | Ethan Pollack Dalton Norwood Hector Caceres Babusai Rapaka Isaac E. Perry Usman Barlass Rachel Mitchell Jessica McCreight Shajan Peter Ramzi Mulki Ali Ahmed Kondal Kyanam Sergio A. Sánchez‐Luna |
| author_facet | Ethan Pollack Dalton Norwood Hector Caceres Babusai Rapaka Isaac E. Perry Usman Barlass Rachel Mitchell Jessica McCreight Shajan Peter Ramzi Mulki Ali Ahmed Kondal Kyanam Sergio A. Sánchez‐Luna |
| author_sort | Ethan Pollack |
| collection | DOAJ |
| description | Abstract Objectives This study aimed to characterize the clinical outcomes, safety, and efficacy of lumen‐apposing metal stents (LAMS) in treating benign gastrointestinal strictures. Methods A single‐center retrospective review of all patients who underwent LAMS placement for benign strictures from June 2017 to July 2023. Primary outcomes were technical success, early clinical success, late clinical success (LCS), and sustained post‐LAMS clinical success (SPLCS). Secondary outcomes included stent dwell time, stenosis changes, adverse events, reintervention rates, and symptomatology evaluation. Results Thirty‐five patients underwent placement of 42 LAMS (74% female, mean age: 54.2 ± 11.7 years). Anastomotic strictures accounted for 64% of cases (N = 27, 45% at the gastrojejunal anastomosis). The median STD was 91.0 days (interquartile range [IQR]: 55.0–132.0). Technical success was obtained in all cases. Early clinical successand LCS were achieved in 80% of cases overall. SPLCS was achieved in 45% (n = 15) of cases. The overall reintervention rate was 63%, with a median time to reintervention being 50.5 days (IQR: 24–105). adverse events occurred in 28% (n = 12) overall, with a 24% migration rate (n = 10). Follow‐up was completed in 83% of cases with a median duration of 629 days (range: 192.0–1297.0). Overall symptom improvement occurred in 79% (n = 27) during indwelling LAMS versus 58% and 56% at 30‐ and 60‐days post‐removal, respectively. Conclusions LAMS for benign gastrointestinal strictures are associated with high technical and early clinical success/LCS rates, positive quality‐of‐life metrics, and a tolerable adverse event rate. Overall, recurrence of symptoms and high reintervention rates post‐LAMS removal reinforce the difficulty in managing benign gastrointestinal strictures but also argue for LAMS as a definitive therapy in select cases. |
| format | Article |
| id | doaj-art-02adc42bf49d4991a4988d79f6904c4f |
| institution | DOAJ |
| issn | 2692-4609 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj-art-02adc42bf49d4991a4988d79f6904c4f2025-08-20T03:13:50ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70005Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy?Ethan Pollack0Dalton Norwood1Hector Caceres2Babusai Rapaka3Isaac E. Perry4Usman Barlass5Rachel Mitchell6Jessica McCreight7Shajan Peter8Ramzi Mulki9Ali Ahmed10Kondal Kyanam11Sergio A. Sánchez‐Luna12Department of Internal MedicineThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineUAB Minority Health and Health Equity Research CenterThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineUAB Minority Health and Health Equity Research CenterThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USADepartment of Internal MedicineDivision of Gastroenterology & HepatologyBasil I. Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at Birmingham Heersink School of MedicineBirmingham Alabama USAAbstract Objectives This study aimed to characterize the clinical outcomes, safety, and efficacy of lumen‐apposing metal stents (LAMS) in treating benign gastrointestinal strictures. Methods A single‐center retrospective review of all patients who underwent LAMS placement for benign strictures from June 2017 to July 2023. Primary outcomes were technical success, early clinical success, late clinical success (LCS), and sustained post‐LAMS clinical success (SPLCS). Secondary outcomes included stent dwell time, stenosis changes, adverse events, reintervention rates, and symptomatology evaluation. Results Thirty‐five patients underwent placement of 42 LAMS (74% female, mean age: 54.2 ± 11.7 years). Anastomotic strictures accounted for 64% of cases (N = 27, 45% at the gastrojejunal anastomosis). The median STD was 91.0 days (interquartile range [IQR]: 55.0–132.0). Technical success was obtained in all cases. Early clinical successand LCS were achieved in 80% of cases overall. SPLCS was achieved in 45% (n = 15) of cases. The overall reintervention rate was 63%, with a median time to reintervention being 50.5 days (IQR: 24–105). adverse events occurred in 28% (n = 12) overall, with a 24% migration rate (n = 10). Follow‐up was completed in 83% of cases with a median duration of 629 days (range: 192.0–1297.0). Overall symptom improvement occurred in 79% (n = 27) during indwelling LAMS versus 58% and 56% at 30‐ and 60‐days post‐removal, respectively. Conclusions LAMS for benign gastrointestinal strictures are associated with high technical and early clinical success/LCS rates, positive quality‐of‐life metrics, and a tolerable adverse event rate. Overall, recurrence of symptoms and high reintervention rates post‐LAMS removal reinforce the difficulty in managing benign gastrointestinal strictures but also argue for LAMS as a definitive therapy in select cases.https://doi.org/10.1002/deo2.70005gastrointestinal disordersgastrointestinal endoscopesgastrointestinal tractstentsstrictures |
| spellingShingle | Ethan Pollack Dalton Norwood Hector Caceres Babusai Rapaka Isaac E. Perry Usman Barlass Rachel Mitchell Jessica McCreight Shajan Peter Ramzi Mulki Ali Ahmed Kondal Kyanam Sergio A. Sánchez‐Luna Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? DEN Open gastrointestinal disorders gastrointestinal endoscopes gastrointestinal tract stents strictures |
| title | Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? |
| title_full | Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? |
| title_fullStr | Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? |
| title_full_unstemmed | Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? |
| title_short | Lumen‐apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures: Is there a role for definitive therapy? |
| title_sort | lumen apposing metal stents provide early and late clinical benefits for the management of benign gastrointestinal strictures is there a role for definitive therapy |
| topic | gastrointestinal disorders gastrointestinal endoscopes gastrointestinal tract stents strictures |
| url | https://doi.org/10.1002/deo2.70005 |
| work_keys_str_mv | AT ethanpollack lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT daltonnorwood lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT hectorcaceres lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT babusairapaka lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT isaaceperry lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT usmanbarlass lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT rachelmitchell lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT jessicamccreight lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT shajanpeter lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT ramzimulki lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT aliahmed lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT kondalkyanam lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy AT sergioasanchezluna lumenapposingmetalstentsprovideearlyandlateclinicalbenefitsforthemanagementofbenigngastrointestinalstricturesistherearolefordefinitivetherapy |