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

Liu, Xiaoqin; Zhou, Min; Shi, Wenxin; Qi, Yiying; Liu, Hui; Li, Bin; Xu, Huilin

doi:10.4253/wjge.v9.i9.494

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Different methods for endoscopic removal of an embedded PCSEMS have been described [100][101][102][103][104][105][106]. Most studies have reported on the use of the stent-in-stent technique, which relies on the placement of an additional FCSEMS fully overlapping the location of the embedded PCSEMS.…”

Section: Factors Predicting Successful Treatmentmentioning

confidence: 99%

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

et al. 2021

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Main recommendations Malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliation of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass.Strong recommendation, high quality evidence. 2 ESGE recommends brachytherapy as a valid alternative, alone or in addition to stenting, in esophageal cancer patients with malignant dysphagia and expected longer life expectancy.Strong recommendation, high quality evidence. 3 ESGE recommends esophageal SEMS placement for sealing malignant tracheoesophageal or bronchoesophageal fistulas. Strong recommendation, low quality evidence. 4 ESGE does not recommend SEMS placement as a bridge to surgery or before preoperative chemoradiotherapy because it is associated with a high incidence of adverse events. Other options such as feeding tube placement are preferable. Strong recommendation, low quality evidence. Benign disease 5 ESGE recommends against the use of SEMSs as first-line therapy for the management of benign esophageal strictures because of the potential for adverse events, the availability of alternative therapies, and their cost. Strong recommendation, low quality evidence. 6 ESGE suggests consideration of temporary placement of self-expandable stents for refractory benign esophageal strictures. Weak recommendation, moderate quality evidence. 7 ESGE suggests that fully covered SEMSs be preferred over partially covered SEMSs for the treatment of refractory benign esophageal strictures because of their very low risk of embedment and ease of removability. Weak recommendation, low quality evidence. 8 ESGE recommends the stent-in-stent technique to remove partially covered SEMSs that are embedded in the esophageal wall. Strong recommendation, low quality evidence. 9 ESGE recommends that temporary stent placement can be considered for the treatment of leaks, fistulas, and perforations. No specific type of stent can be recommended, and the duration of stenting should be individualized. Strong recommendation, low quality of evidence. 10 ESGE recommends considering placement of a fully covered large-diameter SEMS for the treatment of esophageal variceal bleeding refractory to medical, endoscopic, and/or radiological therapy, or as initial therapy for patients with massive bleeding. Strong recommendation, moderate quality evidence.

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Section: Factors Predicting Successful Treatmentmentioning

confidence: 99%

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

et al. 2021

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“…For patients with embedded esophageal stent and hyperplasia-induced stenosis, the SIS technique under endoscopy has been demonstrated to be effective and safe (7,17,19). We therefore adapted the SIS technique for the interventional radiology approach.…”

Section: Discussionmentioning

confidence: 99%

Stent-in-stent technique under fluoroscopy for removal of embedded esophageal stent: a retrospective case series

Yang

Wang

Yin

et al. 2022

Quant Imaging Med Surg

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Background: Treatment of complications after esophageal stent placement and methods for removal of stents need to be improved. The purpose of this study was to evaluate the safety and efficacy of stent-in-stent (SIS) removal of esophageal stent under fluoroscopy.Methods: This study analyzed the clinical data of consecutive patients undergoing esophageal stent removal by the SIS technique under fluoroscopy. The procedure was performed under local anesthesia on conscious sedated patients. Under fluoroscopy, a second esophageal stent was released within the lumen of the first esophageal stent. The second stent was larger than the first, with both ends protruding 1-2 cm beyond the ends of the first stent. Four weeks later, both esophageal stents were removed by the SIS technique under fluoroscopy. All procedures were performed by the same interventional radiologist (with >10 years of experience).Results: A total of 25 patients were treated by the SIS removal technique. In 23 patients, the first esophageal stent was easily removed by the SIS technique; in the other 2 patients, stent fracture occurred, and some residual nitinol wire had to be removed endoscopically. No serious complications occurred in any patient. Conclusions:The SIS removal technique appears to be a safe and effective method for removal of embedded esophageal metallic stents.

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“…For patients with embedded esophageal stent and hyperplasia-induced stenosis, the SIS technique under endoscopy has been demonstrated to be effective and safe 7,16,18 . We therefore adapted the SIS method for the interventional radiology approach.…”

Section: Discussionmentioning

confidence: 99%

Stent-in-stent technique under fluoroscopy for removal of embedded esophageal stent

Wang

Yin

et al. 2021

Preprint

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Background: Treatment of complications after esophageal stent placement and methods for removal of stents need to be improved. The purpose of this study was to evaluate the safety and efficacy of stent-in-stent (SIS) removal of esophageal stent under fluoroscopy.Methods: This study retrospectively analyzed the clinical data of consecutive patients undergoing esophageal stent removal by SIS under fluoroscopy. Under awake condition, local anesthesia, and fluoroscopic monitoring, a second esophageal stent was placed in the first esophageal stent. Four weeks later, both esophageal stents were removed by the SIS technique under fluoroscopy.Results: A total of 12 patients were treated by the SIS removal technique. In 10 patients, the first esophageal stent was easily removed by the SIS method; in the other 2 patients, stent fracture occurred, and some residual nitinol wire had to be removed endoscopically. No serious complications occurred in any patient.Conclusions: The SIS removal technique appears to be a safe and effective method for removal of embedded esophageal metallic stents.

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

Cited by 3 publications

References 10 publications

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

Stent-in-stent technique under fluoroscopy for removal of embedded esophageal stent: a retrospective case series

Stent-in-stent technique under fluoroscopy for removal of embedded esophageal stent

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