{
  "abstract": "VacStent GI for Oesophageal Transmural Defects: 2-Year UK Multi-centre outcomesIntroduction Endoscopic vacuum therapy (EVT) is an established method for treating gastrointestinal transmural defects, particularly anastomotic dehiscence following oesophageal resections. These complications are typically linked with high rates of morbidity and mortality and often necessitate long hospital stays. Traditional sponge therapy requires frequent exchanges and patients are dependant on either parenteral nutrition or distal feeding because it occludes the lumen. The VacStent GI (MicroTech) is an innovative device that combines the benefits of fully covered self-expanding metal stents (fcSEMS) with EVT principles, enabling earlier resumption of liquid enteral nutrition.Methods A prospective multi-centre case series was conducted in the United Kingdom (UK), involving patients treated for transmural oesophageal defects with the VacStent GI between October 2023 and December 2025. The primary endpoint was clinical success (defined as both endoscopic and radiological evidence of defect closure). Secondary endpoints included technical success (defined as successful deployment and removal of the stent), the number of VacStent GI exchanges, adverse events, and time to defect closure.Results A total of 47 VacStent GI devices were implanted in 24 patients. Of these, 13 patients (54.2%) had anastomotic leak after oesophageal resection, seven (29.1%) had iatrogenic defects, and four (16.7%) had idiopathic/Boerhaave’s syndrome. 75% (16/24) were male with a median age of 65 years (IQR 56-72.5). The median defect size was 10 mm (IQR 5-11.25). Clinical success was achieved in 18 patients (75%), while technical success was achieved in all cases. Median time to defect closure was 11 days (IQR 7.25-14), with a median of one exchange needed (IQR 0-2). Of the six unsuccessful cases, three involved defects in a gastric conduit, two had large cavities, and one patient was unfit for stent exchange. No serious adverse events were noted in this series.Conclusions VacStent GI represents a promising intervention for the treatment of oesophageal transmural defects. This series has demonstrated that it is both safe and effective, achieving a clinical success rate of 75%. Standardised pathways and protocols are needed for better patient selection, to optimise management and improve outcomes for this challenging patient population.Abstract P12 Table 1Patient Characteristics and outcomesNumber of Patients [N]24(47 stents)Age [years] (IQR)65 (56-72.5)Male [N] (%)16/24 (75)Aetiology of Defect [N] (%) Anastomotic Leak Iatrogenic Perforation Boerhaave’s syndrome13 (54.2)7 (29.1)4 (75)Median Defect Size [mm] (IQR) 10 (5-11.25)Clinical Success Rate [N] (%)18 (75)Technical Success Rate [N] (%)24 (100)Median Closure time [Days] (IQR)11 (5-14)Mortality [N] (%)0 (0)VACSTENT related Adverse Events [N] (%)2 (8)Serious Adverse Events [N] (%)0 (0)",
  "authors": [
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "David Leonard"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Rawen Kader"
    },
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom",
        "Emirates Hospital Group Dubai, Dubai, United Arab Emirates"
      ],
      "name": "Sherif Awad"
    },
    {
      "affiliations": [
        "Emirates Hospital Group Dubai, Dubai, United Arab Emirates"
      ],
      "name": "Ahmed M El-Sharkawy"
    },
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom"
      ],
      "name": "Paul Leeder"
    },
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom"
      ],
      "name": "Rajeev Singh"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Borzoueh Mohammadi"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Khaled Dawas"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Omer Ahmad"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Matthew Banks"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "David Graham"
    },
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom"
      ],
      "name": "Andy Cole"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Mohamed Hussein"
    },
    {
      "affiliations": [
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom"
      ],
      "name": "Nila Tewari"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Rami Sweis"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Jonathan Moore"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Yassar Qureshi"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom",
        "University College London, London, United Kingdom"
      ],
      "name": "Laurence Lovat"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom",
        "University Hospitals of Derby and Burton NHS trust, Derby, United Kingdom"
      ],
      "name": "Nasar Aslam"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom",
        "University College London, London, United Kingdom"
      ],
      "name": "Vinay Sehgal"
    }
  ],
  "title": "P12 Findings from a United Kingdom multi-centre study on the use of VacStent for treating transmural gastrointestinal defects in the oesophagus",
  "uid": "04d86232-66a7-5692-acfa-ff7f69bc30d3"
}