{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:10:51Z","timestamp":1792671051784,"version":"4.5.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background:\u2002Delayed gastrointestinal (GI) bleeding and stent migration are known adverse events which may occur following placement of lumen-apposing metal stents (LAMSs). <\/jats:p><jats:p>\n          Methods:\u2002All consecutive patients who underwent LAMS placement between May 2011 and June 2017\u200aat a single tertiary medical center were included. Demographics and procedural details were prospectively collected. Post-procedure follow-up and outcome measures were retrospectively collected. The cumulative risks of migration and LAMS-related GI bleeding were estimated using the life-table method. Risk predictors were assessed using Cox proportional hazards models.<\/jats:p><jats:p>\n          Results:\u2002We analyzed 250 patients (64.8\u200a% men; median age 71.6 [interquartile range (IQR) 57.9\u200a\u2013\u200a83.6]). Median follow-up was 78.5 days (IQR 31\u200a\u2013\u200a246.5 days). Thirty-four stent migrations (13.6\u200a%) occurred (5 symptomatic). On multivariable analysis, associations with migration included nasocystic drains (hazard ratio [HR] 6.5, 95\u200a% confidence interval [CI] 2.2\u200a\u2013\u200a19.3), pancreatic fluid collections (PFCs; HR 4.2, 95\u200a%CI 1.8\u200a\u2013\u200a10.1), and double-pigtail stents (HR 2.4, 95\u200a%CI 1.2\u200a\u2013\u200a4.9). Migration risk at 12 months was 25.5\u200a% (95\u200a%CI 17.9\u200a%\u200a\u2013\u200a35.7\u200a%) and was higher for PFCs 48.9\u200a% (33.4\u200a%\u200a\u2013\u200a66.9\u200a%) than other indications 8.4\u200a% (4.9\u200a%\u200a\u2013\u200a17.5\u200a%; P\u200a&lt;\u200a0.001). LAMSs placed for longer durations (i.\u200ae. enteral anastomoses, biliary and gallbladder drainage) presented an 8.4\u200a% cumulative risk at 2 years. There were 13 LAMS-related GI hemorrhages (5.2\u200a%), two of them fatal, presenting a median of 3 days (IQR 1\u200a\u2013\u200a9 days) after deployment. The cumulative risk of bleeding at 12 months was 6.9\u200a% (3.6\u200a%\u200a\u2013\u200a12.7\u200a%). <\/jats:p><jats:p>\n          Conclusions:\u2002LAMS migration occurs in 1 out of 7 cases and is most common when treating PFCs. Bleeding related to LAMS placement occurs much less commonly but can be life-threatening.<\/jats:p>","DOI":"10.1055\/a-0581-9040","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T23:48:02Z","timestamp":1520466482000},"page":"386-395","source":"Crossref","is-referenced-by-count":45,"title":["Cumulative risks of stent migration and gastrointestinal bleeding in patients with lumen-apposing metal stents"],"prefix":"10.1055","volume":"50","author":[{"given":"Francisco","family":"Garcia-Alonso","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n","family":"Sanchez-Ocana","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Pe\u00f1as-Herrero","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Law","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Sevilla-Ribota","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Torres-Yuste","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Gil-Sim\u00f3n","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"de la Serna Higuera","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Perez-Miranda","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Universitario R\u00edo Hortega, Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,3,7]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0581-9040.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T14:23:46Z","timestamp":1546439026000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0581-9040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,7]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2018,3,27]]},"published-print":{"date-parts":[[2018,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0581-9040","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,7]]}}}