CURRENT SITUATION AND FUTURE PROSPECTS OF THE LUMEN-APPOSING METAL STENT

Abstract

The lumen-apposing metal stent (LAMS) is a fully covered, braided stent with bilateral anchor flanges. Fully expanded, the flanges are designed to hold tissue layers in apposition. This novel LAMS has been evaluated and found to have high technical and clinical success for endoscopic ultrasound (EUS)-guided pancreatic fluid collection. Since it has a large diameter, the upper gastrointestinal endoscope can be inserted into the stent lumen. The LAMS is also effective for necrosectomy against walled-off necrosis. In addition, there are reports of treatment methods in which the LAMS is used in EUS-guided choledochoduodenostomy and EUS-guided gallbladder drainage (EUS-GBD). There are also reports of removal of gallstones using the EUS-GBD route with the LAMS. As a new attempt to treat gastric outlet obstruction, EUS-guided gastrojejunostomy using the LAMS has been developed in recent years. The LAMS may provide more than several novel endoscopic therapeutic options as alternatives to surgery.