Extraction of migrated self-expanding esophageal metal stents

Abstract

Background: When self-expanding metal stents are used in the palliative treatment of malignant stenoses complications can occur and require the endoscopic extraction of the stent.

Methods: Three Gianturco-Z stents and two EsophaCoil stents had to be extracted because of migration (4 patients) and strangulation of healthy esophageal tissue between the coil loops during EsophaCoil stent release (1 patient). Because of the strong expansion force of the Gianturco-Z stent, the plastic sheath of a polypectomy snare was replaced by the steel sheath of a basket used for mechanical lithotripsy of bile duct stones. The sufficient resistance of the steel sheath allowed the stents to be compressed. The EsophaCoil stents were gradually retracted with a polypectomy snare over a plastic tube.

Results: All stents could be extracted successfully. There were no severe complications related to extraction.

Conclusion: By means of the endoscopic extraction techniques described above, it is possible to safely remove self-expanding esophageal stents.