Solving the problem of difficult stent removal due to tissue ingrowth in partially uncovered esophageal self-expanding metal stents.
Partially uncovered stents provide a better fixation to the esophageal wall than fully covered stents, but indication is limited to palliation because stent removal is compromised by mucosal ingrowth. After an unsuccessful attempt to remove a partially uncovered Evolution stent (Cook Medical Inc, Bloomington, IN) we placed a Polyflex stent (Boston Scientific, Natick, MA) inside the first stent, overlapping at the lower part to press the tissue out of the stent mesh. Both stents were easily removed 3 days later. By adopting this procedure to scheduled stent removals, partially uncovered SEMS may be used to prevent the frequently observed migrations of fully-covered stents in the treatment of esophageal perforation or anastomotic leakage.
Langer
Felix B
FB
Upper Gastrointestinal Service, University Clinic of Surgery, Medical University of Vienna, Vienna, Austria.
Schoppmann
Sebastian F
SF
Prager
Gerhard
G
Riegler
Franz M
FM
Zacherl
Johannes
J
D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology; D020878:Device Removal / Q000379:methods*; D004940:Esophageal Stenosis / Q000150:complications / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006097:Granulation Tissue / Q000473:pathology; D006801:Humans; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment; D015607:Stents
D008670:Metals