Abbreviation:LAMS (lumen-apposing metal stent)
- 1.Conventional multistep procedure with double pigtail plastic stents; this approach involves needle puncture and advancement of a guidewire, over which a balloon or catheter dilation is performed, followed by deployment of 1 or more plastic stents with or without a second guidewire. This technique may also be used for deployment of an esophageal or biliary fully covered self-expandable metal stent.
- 2.Cold coaxial LAMS over a guidewire; this approach involves needle puncture and advancement of a guidewire, over which a balloon or catheter dilation is performed, followed by deployment of a LAMS.
- 3.LAMS with integrated electrocautery over a guidewire; this approach involves needle puncture and advancement of a guidewire without the need for dilation, followed by LAMS deployment.
- 4.LAMS with integrated electrocautery without a guidewire; in this approach, the cystogastrostomy is performed by the use of freehand cautery-assisted puncture and direct advancement of the device into the collection, followed by deployment of the LAMS.
- https://www.videogie.org/cms/asset/15ab3db9-d13a-45d3-89bf-8a29dcf499f1/mmc1.mp4Loading ...Video 1
Demonstrative video outlining the evolution of EUS-guided cystogastrostomy, from the conventional multistep procedure with several device exchanges, to a simpler procedure using a coaxial lumen-apposing metal stent with a cautery-enhanced delivery system.
This study was supported in part by a development grant from the Department of Medicine at Emory University School of Medicine.
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