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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

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Coaxial Double-Pigtail Stent Placement: A Simple Solution to Decrease Bleeding Risk Associated With Lumen-Apposing

Shehroz Aslam¹, Zaid Ansari¹, Mustafa Alani²

¹Internal Medicine, Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA.

|August 2, 2021

Summary

This summary is machine-generated.

Lumen-apposing metal stents (LAMS) treat pancreatic fluid collections, but a case report highlights a rare complication. A patient experienced severe gastrointestinal bleeding eight weeks after LAMS placement, suggesting further research into stent placement is needed.

Keywords:

cystogastrostomy gastrointestinal hemorrhage lams pancreatic fluid collections pseudoaneurysm

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Area of Science:

Gastroenterology
Interventional Endoscopy
Gastrointestinal Bleeding

Background:

Endoscopic cystogastrostomy with lumen-apposing metal stents (LAMS) is a primary treatment for symptomatic pancreatic fluid collections (PFCs).
The routine coaxial placement of a double-pigtail stent (DPS) through LAMS remains a subject of debate.
Potential benefits include preventing stent-related mucosal erosion and subsequent complications.

Observation:

A patient developed a massive gastrointestinal bleed eight weeks post-LAMS placement.
The bleeding was attributed to a splenic artery pseudoaneurysm.
This complication led to a complex hospitalization.

Findings:

The case suggests a potential link between LAMS placement and delayed bleeding complications.
Splenic artery pseudoaneurysm formation is a rare but serious adverse event.
The theoretical benefit of coaxial DPS placement to mitigate LAMS erosion was not observed in this instance.

Implications:

This case underscores the need for further investigation into the optimal management of LAMS placement for PFCs.
It highlights the importance of monitoring for delayed bleeding complications after LAMS procedures.
Further research is warranted to evaluate the protective role of coaxial DPS placement in preventing LAMS-related bleeding events.