Abstract
BACKGROUND: Endoscopic ultrasound (EUS)-guided drainage using lumen-apposing metal stents (LAMS) is the first line choice for treatment of pancreatic fluid collections (PFCs). This study evaluated the technical success, clinical success, and adverse events (AE) associated with the Hot AXIOS electrocautery-enhanced LAMS for pancreatic pseudocysts (PPs). METHODS: This retrospective cohort study included 45 patients with PPs undergoing Hot AXIOS stent placement between 2019 and 2021. Clinical and technical success were assessed. AEs were graded based on severity and timing. Survival analysis and the Kaplan-Meier curve were used in the study. RESULTS: Technical success was achieved in 97.78% (44/45) cases and clinical success in 95.56% (43/45). Patients with a previous history of PP intervention were significantly more likely to experience moderate to severe AE (P = 0.009). Removal time of stent was significantly longer in patients with moderate or severe AE (median 70 vs 34.5 days, P = 0.005). Transition of PP to walled-off necrosis was associated with moderate or severe AE in comparison with mild or no AE (P < 0.001). CONCLUSION: Hot AXIOS stents demonstrated high clinical and technical success rates for PP drainage. Patients with a history of prior interventions for PPs were at significantly higher risk of AE. Closer monitoring is recommended in patients with delayed removal. Future studies should incorporate a multicenter design and control groups with standardized success rates and AE definitions.