Magnetic compression may achieve tissue remodeling via pressure induced ischemic necrosis. We describe the technique and patency of side-to-side GEA created by magnetic compression tissue remodeling and maintained with covered stents in a canine model. Methods: Enteral (EM) and Gastric (GM) rare-earth disc magnets modified with cutting edges are used in 30Kg anesthetized hounds. The EM is advanced into the proximal small bowel attached to a forceps extending from the tip of an Olympus CF1T- 100 colonoscope. The forceps is exchanged for a.035 stainless steel guidewire and the endoscope withdrawn, leaving the EM on the wire behind. A pushing catheter is advanced over the wire and the combination of withdrawing the guidewire or advancing the pushing catheter allow the EM to be advanced or withdrawn to achieve planar proximity to the gastric bubble seen fluoroscopically. The GM is endoscopically advanced to the stomach and direct opposition of the EM and GM is achieved via coordinated endoscopic and fluoroscopic manipulation. A palpable click is observed when the EM/GM coupling occurs. Endoscopic mucosal clips placed around the GM to mark the site. Ischemic pressure necrosis occurs in 5-7 days and EM/GM are excreted. The GEA is confirmed endoscopically and fluoroscopically. A partially or completely covered with adherent polyurethane, 12mm(d)-flared Z -stent (Wilson-Cook Med.) is placed to maintain patency. Re-inspection was done at 1 mo., then Q2 mos. Animal weight and food intake was monitored. Necropsy was performed upon evidence of stent malfunction. Results: After adjustments for EM/GM size, strength, and cutting edge, the procedure has been performed on 9 subjects. GEA was confirmed and stented in all but one case in which premature anastomosis closure occurred. There were no instances of bleeding, peritonitis, or dehiscence. Partially covered stents (Group 1, n=6) patency: m 90d (r 57-147). Completely covered stents (Group 2, n=3) patency: 5 mo. (n=1), 6 mo. (n=2). Partial or complete occlusions of Group 1 stents occured due to tissue ingrowth in areas of membrane detachment. In Group 2, one dog was sacrificed at 5 mo. due to breakage of the stent but retention of patency. Conclusions: Magnetic compression can successfully create GEA. Using this technique, GEA can be created non-operatively under combined endoscopic and fluoroscopic assistance. Covered stent placement maintains durable GEA patency.