en Gastroenterology Gastroenterology Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><b>&nbsp;&nbsp;</b><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp; Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">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).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> 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. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> 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 (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> = 0.009). Removal time of stent was significantly longer in patients with moderate or severe AE (median 70 vs 34.5 days, </span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> = 0.005). Transition of PP to walled-off necrosis was associated with moderate or severe AE in comparison with mild or no AE (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"> < 0.001). </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion:</b> 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.</span></span></span></span></span></span></span></span><br> &nbsp; Pancreatic pseudocysts, Hot AXIOS, Lumen-apposing metal stents, Endoscopy 896 904 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9463-1&slc_lang=en&sid=1 Esmaeil Hamzehnava Esmail.hznv@gmail.com 200319475328460093124 0009-0004-4913-0989 No Department of Internal Medicine, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Farhad Zamani zamani.farhad@gmail.com 200319475328460093125 0009-0009-4238-5344 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Hossein Ajdarkosh ajdarkosh1345@yahoo.com 200319475328460093126 200319475328460093126 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mahmoodreza Khoonsari khonsarimahmoodreza@gmail.com 200319475328460093127 200319475328460093127 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Amirhossein Faraji amir.hfaraji6@gmail.com 200319475328460093128 0009-0005-5595-7840 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Elham Sobhrakhshankhah elham.internist@gmail.com 200319475328460093129 200319475328460093129 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Masoumeh Nejatifar rnejatifar@gmail.com 200319475328460093130 200319475328460093130 No Epidemiology Department, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shahaboddin Dolatkhah Shahab_dolatkhah@yahoo.com 200319475328460093131 200319475328460093131 No Department of Internal Medicine, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mohadese Sedighi Pashaki mohadese.sedighi1373@gmail.com 200319475328460093132 0009-0000-9605-2611 No 1. Department of Internal Medicine, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Fahimeh Safarnezhad Tameshkel Fahime.1615@yahoo.com 200319475328460093133 200319475328460093133 No 2. Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Roghayeh Sahraie dr.sahraie@gmail.com 200319475328460093134 200319475328460093134 No Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mehdi Nikkhah nikkhah.m@iums.ac.ir 200319475328460093135 200319475328460093135 Yes Gastrointestinal and Liver Diseases Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran