Clin Endosc.  2024 Sep;57(5):588-594. 10.5946/ce.2023.169.

Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions

• Jang DK
• Lee DW
• Kim SH
• Cho KB
• Lakhtakia S

• KMID: 2559207
• DOI: http://doi.org/10.5946/ce.2023.169

Abstract

Endoscopic ultrasound (EUS)-guided interventions have evolved rapidly in recent years, with dedicated metal stents playing a crucial role in this process. Specifically, the invention of biflanged short metal-covered stents, including lumen-apposing metal stents (LAMS), and modifications in a variety of tubular self-expandable metal stents (SEMS), have led to innovations in EUS-guided interventions. LAMS or non-LAMS stents are commonly used in the EUS-guided drainage of pancreatic fluid collections, especially in cases of walled-off necrosis. Additionally, LAMS is commonly considered for drainage of the EUS-guided gallbladder or dilated common bile duct and EUS-guided gastroenterostomy. Fully or partially covered tubular SEMS with several new designs are being considered for EUS-guided biliary drainage. This review focuses on advances in SEMS for EUS-guided interventions and discusses related research results.

Keyword

Drainage; Endosonography; Self expandable metallic stents

Figure

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  Fig. 1. Commercially available electrocautery-enhanced lumen-apposing metal stents. (A) Hot AXIOS (Boston Scientific Corporation). (B) Niti-S Hot SPAXUS (Taewoong Medical).

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  Fig. 2. A case of EUS-guided walled-off necrosis treated using a lumen-apposing metal stent (15 mm, 1 cm, Hot AXIOS; Boston Scientific Corporation). (A) A large walled-off necrosis is noted around the pancreas. (B). A sonographic view of stent deployment. (C) An endoscopic view of the lumen-apposing metal stent in the stomach. (D) An X-ray view of the stent.

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  Fig. 3. A case of EUS-guided hepatico-gastrostomy treated using a hybrid self-expandable metal stent (10 mm, 8 cm, Giobor; Taewoong Niti-S Biliary Covered Stent). (A) Dilated bile ducts are noted in a patient with cholangiocarcinoma. (B, C) A process of stent deployment. (D) An X-ray view of the stent (arrow).

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  Fig. 4. A case of EUS-guided gallbladder drainage treated using a lumen-apposing metal stent (10 mm, 2 cm, Hot AXIOS; Boston Scientific Corporation). (A) Acute cholecystitis is noted on computed tomography. (B) A sonographic view of the stent deployment. (C) An endoscopic view of the lumen-apposing metal stent in the duodenum. (D) An X-ray view of the stent (circle).

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  Fig. 5. Newly developed self-expandable metal stents for endoscopic ultrasound-guided interventions. (A) Tornado stent (S&G Biotech Inc.). (B) Spring Stopper Stent (Taewoong Medical).

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