Removal of retrievable esophageal and gastrointestinal stents: experience in 113 patients.
OBJECTIVE
Although there are frequent clinical situations in which esophageal and gastrointestinal stents should be removed, nonsurgical stent removal has been difficult. The purpose of our study was to describe the safety and efficacy of removing the retrievable nitinol stents with a retrieval hook.


METHODS
Under fluoroscopic guidance, the removal of 119 esophageal, six gastroduodenal, and five rectal retrievable stents was attempted in 113 patients using a retrieval hook. Indications for stent removal included migration (n = 35), severe pain (n = 23), formation of a new stricture (n = 13), incomplete stent expansion (n = 7), airway compression (n = 2), esophagorespiratory fistula (n = 2), malpositioned stent (n = 1), and hematemesis (n = 1). The remaining 46 stents were electively removed.


RESULTS
Of the 130 stents, 127 (97.7%) were successfully removed despite the following difficulties: untied drawstrings (n = 4), separation of the stent (n = 3), and fracture (n = 2) or disconnection (n = 2) of a retrieval hook. The removal procedure failed in three cases (2.3%). The causes of failure were the inability to place the hook into the migrated stent (n = 2) and a tight stricture above the migrated stent (n = 1). The procedure-related complications included minor (n = 4) and major (n = 1) bleeding and intramural rupture (n = 3). One patient died of major bleeding after removal of an esophageal stent.


CONCLUSIONS
The stent retrieval hook is useful for removing retrievable esophageal and gastrointestinal stents.
Yoon
Chang Jin
CJ
Department of Radiology, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea.
Shin
Ji Hoon
JH
Song
Ho-Young
HY
Lim
Jin-Oh
JO
Yoon
Hyun-Ki
HK
Sung
Kyu-Bo
KB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000295:instrumentation / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents
D000497:Alloys; C013616:nitinol