Lumen-apposing metal stents for benign gastrointestinal tract strictures: An international multicenter experience

Table 1 Summary of prior studies on lumen-apposing metal stent for benign strictures n (%)

	Majumder et al[11] (2015)	Irani et al[12] (2016)	Yang et al[13] (2017)
Total cases	5	25	30
Age	47.4 (mean)	54 yr (median)	51.6 (mean)
Females	4 (80.0)	18 (72.0)	19 (63.3)
Underwent prior endoscopic dilation	3 (60.0)	20 (80.0)	27 (90.0)
Prior cSEMS	1 (20.0)	1 (4.0)	8 (29.6)
LAMS used
AXIOS 15 mm × 10 mm	5 (100.0)	25 (100.0)	29 (96.7)
AXIOS 10 mm × 10 mm	0	3 (12.0)1	1 (3.3)
Technical success	Not described	25 (100)2	29 (96.7)3
Clinical success	Not described
Short-term		15 (60)4	27 (90.0)5
Long-term			19 (82.6)6
Migration	0	2 (7.0)	2 (8.0)
Median stent dwell time (range)	Not described	92 d (3-273, median)	Not described
Median follow-up, d (range)	120 (84-140)	301 (62-681)	100 (60-139)

¹Three patients initially had an AXIOS 10 mm × 10 mm placed, which was immediately upsized to 15 mm × 10 mm;

²Technical success was defined as appropriate stent placement across the stricture verified endoscopically and fluoroscopically;

³Technical success was defined as successful placement of the LAMS across the stricture;

⁴Clinical success was defined as resolution of underlying symptoms for at least 6 mo after stent placement;

⁵Short-term clinical success was defined as symptom improvement/resolution with indwelling stent;

⁶Long-term clinical success was defined as symptom improvement/resolution after stent removal. LAMS: Lumen-apposing metal stent.

Table 2 Demographics and stricture characteristics

	Proximal esophagus(n = 5)	Distal esophagus(n = 4)	Stomach(n = 6)	Duodenum(n =4)	Colon(n = 2)	Total(n = 21)
Age, mean (yr)	54	68.5	59	65.8	77	62.6
Gender
Male	3 (60.0)	3 (75.0)	2 (33.3)	2 (50.0)		10 (47.6)
Female	2 (40.0)	1 (25.0)	4 (66.7)	2 (50.0)	2 (100.0)	11 (52.4)
Etiology
Post-surgery/radiation	4 (80.0)	3 (75.0)	4 (66.7)	1 (25.0)	2 (100.0)	14 (65.2)
Peptic			1 (16.7)	2 (50.0)		3 (13.0)
Chronic pancreatitis				1 (25.0)		1 (4.3)
Caustic ingestion	1 (20.0)	1 (25.0)	1 (16.7)			3 (13.0)
Types of prior treatments
Balloon dilatation
1			1	1	1	3
2	4	2	2			8
3			1		1	2
> 3		1				1
Fully-covered stents	1	1		1		3
Prior migration	1	1		1		3
Stricturoplasty	1					1

Table 3 Results of lumen-apposing metal stent placement

	Proximal esophagus(n = 5)	Distal esophagus(n = 4)	Stomach(n = 6)	Duodenum(n =4)	Colon(n = 2)	Total(n = 21)
LAMS
15 mm × 10 mm AXIOS	5 (100.0)	2 (50.0)	3 (50.0)	4 (100.0)	2 (100)	16 (76.2)
10 mm × 10 mm AXIOS			2 (33.3)			2 (9.5)
16 mm × 30 mm NAGI		2 (50.0)	1 (16.7)			3 (14.3)
Mean stent dwell time (d)	67.6	56.5	151.2	167.5	55.5	107.2
Technical success	5 (100.0)	4 (100.0)	6 (100.0)	4 (100.0)	2 (100)	21 (100.0)
Clinical success						11
Short-term	5 (100.0)	3 (75.0)	5 (83.3)	4 (100.0)	2 (100)	19 (90.5)
Long-term	1 (25.0)	2 (66.7)	5 (100.0)	3 (75.0)	1 (50.0)	212 (66.7)
Reasons for stent removal
Angulation	1	1				2
Stent migration	1	1		2		4
Stricture overgrowth			2	1		2
Ulceration			1			1
Resolution	1			11		3
Treatments after stent failure
Balloon dilation		2				2
cSEMS	1					1
15 mm × 10 mm AXIOS		1	1	1		3
16 mm × 30 mm NAGI	2	1				3