The electrocautery-enhanced lumen-apposing metal stent (LAMS) has enabled simple direct puncture of walled-off necrosis (WON) under endosonographic guidance [1] [2] [3]. However, the two-step approach (e.g. use of a guidewire and balloon dilation [4]) may be required for solid WON lesions. In the current case, part of the gastric wall moved away from the echoendoscope during stent deployment and was successfully pulled back using an inflated balloon dilator ([Video 1]).
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Kurihara et al. (2024) studied this question.
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