Electrocautery-enhanced LAMS boasts shorter procedure in PCS management

A lumen-apposing metal stent (LAMS) set with the use of an electrocautery delivery system results in a significant reduction in procedure duration and demonstrates safety and effectiveness in managing symptomatic pancreatic fluid collections (PLCs), reports a study.

This multicentre, nonblinded, prospective, Food and Drug Administration (FDA)-approved, investigational device exemption clinical trial included patients with symptomatic PFCs ≥6 cm with ≥70-percent fluid fraction. The research team prospectively followed the participants for safety, efficacy, and resolution of the collections.

A reduction in PFC size of at least 50 percent was the primary endpoint. The researchers also compared the clinical outcomes with a previously published series of LAMS without the cautery-enhanced delivery system.

Thirty patients from seven tertiary care centres in the US were enrolled in this study, all of whom underwent successful placement of the electrocautery-enhanced LAMS. The mean procedure duration was 28.1 minutes, while the corresponding mean stent placement time and fluoroscopy exposures were 5.8 and 1.8 minutes. Eight patients did not undergo fluoroscopy.

Majority of the patients (83.3 percent) achieved the primary endpoint. Two electrocautery-enhanced LAMS-related adverse events were recorded: one bleeding upon stent removal and one stent migration.

Patients who had electrocautery-enhanced LAMS experienced a significantly shorter procedure duration (36 min; p<0.001), with similar technical and clinical outcomes, when compared to those in the comparator noncautery LAMS multicentre trial (n=33; eight tertiary centres).

“Endoscopic decompression is considered a first-line treatment for symptomatic PFCs,” the researchers said. “LAMS with an electrocautery-enhanced delivery system may facilitate this procedure.”