Efficacy and safety of a retrieval hook for removal of retrievable expandable tracheobronchial stents.
OBJECTIVE
To evaluate the efficacy and safety of use of a retrieval hook for removal of retrievable expandable tracheobronchial stents.


METHODS
With fluoroscopic guidance, a retrieval hook was used to remove 45 retrievable expandable tracheobronchial stents in 31 patients. Indications for stent removal included tissue hyperplasia (n = 16), stent migration (n = 10), stent misplacement (n = 2), tumor overgrowth (n = 2), persistent gastrobronchial fistula (n = 1), and incompletely expanded stent (n = 1). Thirteen stents were electively removed after temporary use. The success rate, causes of failure, and complications related to stent removal with a retrieval hook were analyzed.


RESULTS
Forty-one of 45 stents (91.1%) were successfully removed with a retrieval hook. The following difficulties were encountered: disruption of the polyurethane membrane (n = 3) and an untied drawstring (n = 1). The removal procedure failed in four cases (8.9%) because of excessive tissue hyperplasia (n = 4) in the proximal portion of the stent. The hook wire fractured in two of the four failed cases. The overall complication rate was 4.4% (minor bleeding, n = 2).


CONCLUSIONS
For complications with or temporary use of retrievable expandable tracheobronchial stents, removal with a retrievable hook shows promising initial results.
Kim
Jin Hyoung
JH
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea.
Shin
Ji Hoon
JH
Shim
Tae Sun
TS
Yoon
Chang Jin
CJ
Lim
Jin-Oh
JO
Ko
Gi-Young
GY
Yoon
Hyun-Ki
HK
Sung
Kyu-Bo
KB
Song
Ho-Young
HY
D000328:Adult; D000497:Alloys; D001982:Bronchial Diseases / Q000601:surgery*; D001999:Bronchoscopy; D003251:Constriction, Pathologic; D020878:Device Removal / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013525:Surgical Instruments; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol