Pancreatic Necrosectomy Through a Novel Double-flange Lumen-apposing Covered Metal Stent (Video) Andres Sanchez-Yague, Angel Gonzalez-Canoniga, Cristina.

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Endoscopic view revealed blood in the lumen-apposing metal stent (A) with EUS revealing interlacing vessels at the distal flange (B), which was treated.

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Pancreatic Necrosectomy Through a Novel Double-flange Lumen-apposing Covered Metal Stent (Video) Andres Sanchez-Yague, Angel Gonzalez-Canoniga, Cristina Lopez-Muñoz, Andres M. Sanchez-Cantos Video Journal and Encyclopedia of GI Endoscopy Volume 2, Issue 3, Pages 79-83 (December 2014) DOI: 10.1016/j.vjgien.2014.10.001 Copyright © 2014 The Authors Terms and Conditions

Figure 1 (A) Access with the cautery tip of the Hot AXIOS catheter under endosonographic guidance. (B) Deployment of the distal flange under EUS. The distal flange presents a characteristic echogenic mark resembling a mushroom. (C) Deployment of the proximal flange under endoscopic view. Pus flows through the stent. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 79-83DOI: (10.1016/j.vjgien.2014.10.001) Copyright © 2014 The Authors Terms and Conditions

Figure 2 (A) Necrosectomy into the cavity using a net. (B) Pulling a large chunk of necrosis out of the cavity. Extraction might be difficult even through a 15mm opening. (C) Upon resolution the walls of the cavity collapse blocking the distal flange of the stent. Video Journal and Encyclopedia of GI Endoscopy 2014 2, 79-83DOI: (10.1016/j.vjgien.2014.10.001) Copyright © 2014 The Authors Terms and Conditions