The Hot AXIOS™ Stent and Electrocautery Enhanced Delivery System enables therapeutic endoscopists to access a symptomatic pancreatic pseudocyst, walled-off necrosis, gallbladder or bile duct via a transgastric or transduodenal approach to place the stent.
The system combines a cautery-enabled access catheter with the therapeutic Hot AXIOS™ Stent for a streamlined, exchange-free procedure.
The Hot AXIOS™ System is used under combined endoscopic and EUS guidance. Its electrocautery-enhanced delivery system is designed to facilitate smooth, efficient access into the target structure.
Over 400 endoscopists across Europe area already performing drainage procedures with LAMS for PFC/WON and have the ability to offer this novel procedure to non-surgical patients with acute cholecystitis who would previously have had to receive a percutaneous drain.⁴
Meet Hot AXIOS™ Inventor: Why I developed the Hot AXIOS™ for gallbladder drainage
ESGE Recommendations
ESGE recommends that, in patients at high surgical risk, EUS-guided gallbladder drainage (GBD) should be favored over percutaneous gallbladder drainage where both techniques are available, owing to the lower rates of adverse events and need for re-interventions in EUS-GBD.⁶
Why & when is EUS Gallbladder drainage needed ?
Treatment of choice in high-risk surgical patients
HOT AXIOS™ is a ground-breaking endoscopic option for the management of symptomatic cholecystitis in patients who are at high risk or unsuitable for surgery.
Early laparoscopic cholecystectomy is considered in most cases the treatment of choice for acute cholecystitis. However, in the elderly, in critically ill patients, and in those with significant comorbidities, cholecystectomy is considered a high-risk procedure, and gallbladder drainage (GBD) is recommended as an alternative treatment.¹
Until recently, percutaneous transhepatic gallbladder drainage (PT-GBD) has been the most common GBD technique used in clinical practice but experts across different specialties are including Hot AXIOS™ in their patient pathways.
Published literature has demonstrated clinical and technical success for symptomatic cholecystitis in patients at high risk or unsuitable for surgery by creating a new temporary opening between the gall-bladder and GI tract.
How is the Hot AXIOS™ implanted for gallbladder drainage?
About the Hot AXIOS™ Procedure
The stent is implanted by an endoscopist using a therapeutic EUS scope. The scope is advanced and the transducer used to identify the target structure on the EUS image. The physician may choose to approach the target either transgastrically or transduodenally depending on the patient’s anatomy, and position of the target.
Once the target has been identified the Hot AXIOS™ stent is passed though the working channel of the endoscope and locked into place.
Electrocautery is connected and the tip of the delivery system exposed by unlocking the catheter and moving slowly forward until visible on the EUS image.
After using EUS to look for potential blood vessels, adjusting position to avoid them if necessary, the diathermy pedal is depressed and the delivery system advanced into the target structure with a smooth, steady action.
The first (distal) flange of the stent is released into the target structure, before being retracted to create apposition with the gastric/duodenal wall. Finally the second (proximal) flange is deployed to create the anastomosis, and the delivery system is removed.
