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Safety of lumen-apposing metal stents (LAMS) for pancreatic fluid collection drainage
  1. Barbara M Ryan1,
  2. Suresh Vasam Venkatachalapathy2,
  3. Matthew T Huggett3,
  4. UK and Ireland Hot AXIOS Study Group,
  5. UK and Ireland Hot AXIOS Study Group
  1. 1Department of Gastroenterology, Tallaght Hospital and Trinity College, Dublin, Ireland
  2. 2Department of Gastroenterology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  3. 3Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Barbara Ryan, Department of Gastroenterology, Tallaght Hospital and Trinity College, Tallaght, Dublin 24, Ireland; Barbara.ryan2{at}

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Dear editor,

Bang et al1 reported in Gut their recent experience with the Boston Scientific Hot AXIOS lumen-apposing metal stent (LAMS) in the treatment of walled-off necrosis (WON). They described a concerning 50% (6/12) rate of stent-related adverse events, in particular delayed bleeding (3/12) and buried stent syndrome (2/12). They postulated that rapid decompression of the WON facilitated by the wide-bore LAMS may lead to the LAMS impinging on the internal wall of the collection cavity resulting in damage to adjacent vasculature, causing haemorrhage, or inward migration of the outer flange of the stent causing buried stent …

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  • Contributors BMR, SVV and MTH were all involved in conception, drafting and final approval of the letter.

  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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