title: Trimming a metallic biliary stent using an argon plasma coagulator.
abstract: BACKGROUND
  Distal migration is one of the common complications after insertion of a covered metallic stent. Stent repositioning or removal is not always possible in every patient. Therefore, trimming using an argon plasma coagulator (APC) may be a good alternative method to solve this problem.
  
  
  METHODS
  Metallic stent trimming by APC was performed in 2 patients with biliary Wallstent migration and in another patient with esophageal Ultraflex stent migration. The power setting was 60-100 watts with an argon flow of 0.8 l/min.
  
  
  METHODS
  The procedure was successfully performed and all distal parts of the stents were removed. No significant collateral damage to the nearby mucosa was observed.
  
  
  CONCLUSIONS
  In a patient with a distally migrated metallic stent, trimming of the stent is possible by means of an APC. This new method may be applicable to other sites of metallic stent migration.
authors.affiliation: Gastroenterology Unit, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10310, Thailand. Rungsun@pol.net
authors.forename: Rungsun
authors.initials: R
authors.lastname: Rerknimitr
authors.forename: Pisit
authors.initials: P
authors.lastname: Naprasert
authors.forename: Pradermchai
authors.initials: P
authors.lastname: Kongkam
authors.forename: Pinit
authors.initials: P
authors.lastname: Kullavanijaya
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D020878:Device Removal / Q000379:methods*; D004384:Duodenoscopy / Q000379:methods; D004386:Duodenum; D004564:Electrocoagulation / Q000379:methods*; D016145:Endoscopy, Digestive System; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005548:Foreign-Body Migration / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013270:Stomach