Stent-in-stent technique for removal of embedded partially covered self-expanding metal stents

DaVee, Tomas; Irani, Shayan; Leggett, Cadman L.; Corella, Manuel Berzosa; Grooteman, Karina V.; Song, Louis M. Wong Kee; Wallace, Michael B.; Kozarek, Richard A.; Baron, Todd H.

doi:10.1007/s00464-015-4475-4

Cited by 26 publications

(20 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This technique is highly effective for removal of the embedded stent. However, it requires additional stents, another procedure and increased costs in order to remove a PSEMS 14 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Fully covered self-expandable metal stents (FSEMS) were introduced to avoid these AEs, but consequently are associated with increased risk of stent migration 11 12 . Despite above mentioned stent-related AEs, PSEMS is still commonly used for benign upper gastrointestinal conditions due to perception of its low risk of stent migration 3 11 12 13 14 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

et al. 2018

View full text Add to dashboard Cite

Background and study aims Self-expandable metallic stents (SEMS) have been increasingly used in benign conditions (e. g. strictures, fistulas, leaks, and perforations). Fully covered SEMS (FSEMS) were introduced to avoid undesirable consequences of partially covered SEMS (PSEMS), but come with higher risk of stent migration. Endoscopic suturing (ES) for stent fixation has been shown to reduce migration of FSEMS. Our aim was to compare the outcomes of FSEMS with ES (FS/ES) versus PSEMS in patients with benign upper gastrointestinal conditions. Patients and methods We retrospectively identified all patients who underwent stent placement for benign gastrointestinal conditions at seven US tertiary-care centers. Patients were divided into two groups: FSEMS with ES (FS/ES group) and PSEMS (PSEMS group). Clinical outcomes between the two groups were compared. Results A total of 74 (FS/ES 46, PSEMS 28) patients were included. On multivariable analysis, there was no significant difference in rate of stent migration between FS/ES (43 %) and PSEMS (15 %) (adjusted odds ratio 0.56; 95 % CI 0.15 – 2.00). Clinical success was similar [68 % vs. 64 %; P = 0.81]. Rate of adverse events (AEs) was higher in PSEMS group [13 (46 %) vs. 10 (21 %); P = 0.03). Difficult stent removal was higher in the PSEMS group (n = 5;17 %) vs. 0 % in the FS/ES group; P = 0.005. Conclusions The proportion of stent migration of FS/ES and PSEMS are similar. Rates of other stent-related AEs were higher in the PSEMS group. PSEMS was associated with tissue ingrowth or overgrowth leading to difficult stent removal, and secondary stricture formation. Thus, FSEMS with ES for stent fixation may be the preferred modality over PSEMS for the treatment of benign upper gastrointestinal conditions.

show abstract

“…This technique is highly effective for removal of the embedded stent. However, it requires additional stents, another procedure and increased costs in order to remove a PSEMS 14 24 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Ultimately, three embedded stents were successfully removed without serious complications (Figure 4 ). Previous studies have shown that the stent-in-stent technique is a safe and effective method for removing single embedded esophageal stents[ 10 ]. This is the first report showing that the stent-in-stent technique also applies to the removal of multiple stents that have become embedded in the esophageal wall.…”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic removal of three embedded esophageal self-expanding metal stents

Liu

Zhou

Shi

et al. 2017

WJGE

View full text Add to dashboard Cite

In the report, we describe a case of refractory benign esophageal strictures from esophageal cancer after an operation for the placement of three partially covered self-expanding metal stents (SEMSs), which were all embedded in the esophageal wall. Using the stent-in-stent technique, the three embedded SEMSs were successfully removed without significant complications. To the best of our knowledge, few cases of the successful removal of multiple embedded esophageal SEMSs have been reported in the literature. This case also highlights that the stent-in-stent technique is effective for removing multiple embedded esophageal SEMSs.

show abstract

“…In such situations the "stent-in-stent" technique can be performed. [22][23][24][25] This involves inserting a fully-covered stent within and across the entire PCSEMS. The fully-covered stent induces compression necrosis on the hyperplastic and embedded tissue, freeing the uncovered portion of the partially covered stent.…”

Section: Stenting Techniquementioning

confidence: 99%

“…PCSEMS obviously carry a lower risk of migration and some authors strongly advocate the use of PCSEMS and confirm that the stent-in-stent technique for stent removal is safe and effective. 24,25,74 However, concerns about this technique still exist. Apart from adding a third endoscopic procedure for stent removal, mucosal hyperplasia causing luminal obstruction and dysphagia is a frequent problem.…”

Section: Adverse Eventsmentioning

confidence: 99%

Enteral stents in the management of gastrointestinal leaks, perforations and fistulae

Shehab

Baron

2016

Int J Gastrointest Interv

Self Cite

View full text Add to dashboard Cite

Gastrointestinal leaks and fistulae are grave conditions associated with substantial morbidity and mortality. Expandable stents have shown significant success in the management of leaks and fistulae, providing an efficacious minimally invasive approach in patients who are frequently poor surgical candidates. Most reports, however, are limited by their small size or the pooling of different stents, techniques and locations of leaks and fistulae. Despite the numerous alterations in stent design, migration remains the pivotal drawback of this technique. In this article, we review the current status of expandable stents in the management of gastrointestinal leaks and fistulae, available anti-migration techniques and evolving innovations in stent design.

show abstract

Stent-in-stent technique for removal of embedded partially covered self-expanding metal stents

Abstract: When performed by experienced endoscopists, safe and effective removal of embedded PCSEMS can be achieved via the SIS technique.

Cited by 26 publications

References 44 publications

Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

Successful endoscopic removal of three embedded esophageal self-expanding metal stents

Enteral stents in the management of gastrointestinal leaks, perforations and fistulae

Contact Info

Product

Resources

About