The field of therapeutic endoscopy has seen many recent advancements. One such emerging field is the use of lumen-apposing metal stents (LAMS). Although a few LAMS have been developed, the most commonly reviewed and the only Food and Drug Administration (FDA)-approved LAMS is the Axios stent by Boston Scientific. In 2013, LAMS were initially approved by the FDA for the management of pancreatic fluid collection drainage in the presence walled-off necrosis. Pancreatic fluid collections are traditionally drained with either a plastic stent or a covered biliary self-expanding metal stent. Plastic stents have a double pigtail feature which prevents stent migration. However, their narrow lumen poses limitations as it can lead to early stent occlusion. Fully covered metal stents have larger diameters, allowing improved drainage and decreased stent occlusion but their tubular shape is prone to migration. Consequently, this results in leakage, and frequent retrievals. Over the years, due to their versatility, LAMS now have many off label uses. This includes management of gastric outlet obstruction, superior mesenteric artery syndrome, strictures, gallbladder drainage, and postsurgical collection drainage. In this review, we will be discussing the FDA approved and the nonapproved uses of LAMS.

中文翻译：

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管腔金属支架的新用途：文献综述。

治疗性内窥镜检查领域最近取得了许多进展。此类新兴领域之一是管腔金属支架（LAMS）的使用。尽管已经开发了一些 LAMS，但最常审查且唯一获得美国食品和药物管理局 (FDA) 批准的 LAMS 是波士顿科学公司 (Boston Scientific) 的 Axios 支架。2013 年，LAMS 最初获得 FDA 批准，用于治疗存在围壁性坏死的胰液收集引流。传统上，胰液收集是用塑料支架或覆盖的胆道自膨胀金属支架引流的。塑料支架具有双尾纤功能，可防止支架移位。然而，它们的狭窄管腔存在局限性，因为它可能导致支架早期闭塞。全覆盖金属支架直径较大，可以改善引流并减少支架闭塞，但其管状形状易于迁移。因此，这会导致泄漏和频繁检索。多年来，由于 LAMS 的多功能性，现在有许多标签外用途。这包括胃出口梗阻、肠系膜上动脉综合征、狭窄、胆囊引流和术后收集引流的治疗。在本次综述中，我们将讨论 FDA 批准和未批准的 LAMS 用途。