Dislocated Atkinson tubes: removal and repositioning with a balloon catheter.

Jantsch, H; Lechner, G; Wittich, G R; Wunderlich, M; Karnel, F; Niederle, B

doi:10.1148/radiology.170.3.2464838

Cited by 6 publications

(3 citation statements)

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“…For a stent that has migrated to the stomach, one with a cuff is easy to remove. When there is no proximal cuff, it is challenging and usually requires other devices, such as an inner ring, polypectomy snare, foreign body protection cover, or metal sheath tube [11][12][13][14]. When removing a stent in the stomach under endoscopy, there is a risk of insu cient stent contraction and esophageal injury.…”

Section: Discussionmentioning

confidence: 99%

Removal of Migrated Esophageal Stents in the Stomach Under the Guidance of Fluoroscopy: a Single-center Retrospective Study

Liu

Zhou

et al. 2021

Preprint

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Background: Migrated esophageal self-expandable metal stents (SEMSs) increase the risk of bowel obstruction or perforation. The endoscopic removal of migrated stents is extremely difficult due to the inability to observe the distal end of the stent during retrieval. Here, we report our experience removing migrated esophageal stents in the stomach under the guidance of fluoroscopy.Material and methods: The clinical data of patients with esophageal stents that migrated to the stomach between January 2016 and March 2020 were analyzed retrospectively. A total of 27 patients (9 females and 18 males) were included in this study. Three methods of retrieval were considered: direct removal via a fixed string, direct removal via a retrieval hook, and retrieval via guide wire and gooseneck snare.Results: A total of 28 migrated esophageal stents in the stomachs of 27 patients were successfully removed under the guidance of fluoroscopy by the three methods mentioned above: 10 cases of direct removal via a fixed string, 14 cases of direct removal via a retrieval hook, and 3 cases of retrieval via a guide wire. The stent removal time was 18 (7-60) minutes. During the operation, one patient had a small amount of esophageal bleeding that was cured after symptomatic treatment, and one patient had a residual fracture stent wire that was removed under endoscopy.Conclusion: The removal of migrated esophageal stents in the stomach under the guidance of fluoroscopy is a feasible and safe procedure.

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Section: Discussionmentioning

confidence: 99%

Removal of Migrated Esophageal Stents in the Stomach Under the Guidance of Fluoroscopy: a Single-center Retrospective Study

Liu

Zhou

et al. 2021

Preprint

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“…The methods for extraction of migrated stents in the stomach described in the literature aim to minimize esophageal injury by reducing the size of the stent. The techniques often utilize combinations of endoloops, polypectomy snares, rat-tooth forceps, double-channel endoscopes, metallic sheaths from bile duct stone lithotripsy, biliary stent pushers, foreign body hood protectors, and overtubes [12][13][14][15][16][17][18][19]. All are performed anterograde through the upper gastrointestinal tract, and thus are not applicable in patients with severe esophageal strictures and/or tumors.…”

Section: Discussionmentioning

confidence: 99%

Migrated Esophageal Stent Endoscopic Extraction through Gastrostomy Site in a Patient with Severe Esophageal Stricture

M¹,

B²

2019

J Clin Gastroenterol Treat

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A 36-year-old woman with a history of benign refractory esophageal stricture from gastroesophageal reflux disease was treated with anesophageal stent and a gastrostomy tube 2 months prior to presenting with acute dysphagia and odynophagia. Esophagram and upper endoscopy revealed esophageal stent migration into the stomach and a pinpoint stricture of the distal third of the esophagus, which made retrograde extraction unfeasible. The stent was successfully extracted through the pre-existing gastrostomy site after dilating the site with a controlled radial expansion balloon. This is the first reported case of stent extraction through a gastrostomy site.

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“…The lasso is grasped and pulled back into the pusher while the pusher is advanced against the stent. This maneuver allows constraining of the proximal flange of the stent, facilitating its removal [28] ; (4) A foreign body hood protector in combination with a rat-tooth forceps or snare can be used to facilitate the removal of the stent, reducing the risk of mucosa injury during removal [29] ; (5) An overtube may be used to protect the esophageal mucosa while retrieving the stent with a rat-tooth grasper [30] . Enteroscopy can be used to attempt removal of a stent migrated beyond the duodenum.…”

Section: Endoscopic Removalmentioning

confidence: 99%

Endoscopic management and prevention of migrated esophageal stents

Martins¹,

Retes²,

Medrado³

et al. 2014

WJGE

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The use of self-expandable metallic stents has increased recently to palliate inoperable esophageal neoplasia and also in the management of benign strictures. Migration is one of the most common complications after stent placement and the endoscopist should be able to recognize and manage this situation. Several techniques for managing migrated stents have been described, as well as new techniques for preventing stent migration. Most stents have a "lasso" at the upper flange which facilitates stent repositioning or removal. An overtube, endoloop and large polypectomy snare may be useful for the retrieval of stents migrated into the stomach. External fixation of the stent with Shim's technique is efficient in preventing stent migration. Suturing the stent to the esophageal wall, new stent designs with larger flanges and double-layered stents are promising techniques to prevent stent migration but they warrant validation in a larger cohort of patients.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Endoscopy; Stents; Esophageal cancer; Benign strictures; Complications Core tip: Migration of self-expandable esophageal stents occurs in up to 36% of cases. The lasso system available in most stents provides a safe way to remove or reposition the stent while it is still in the esophagus. However, when the stent migrates into the stomach, other techniques are needed to guarantee a safer retrieval. The use of clipping, suturing or external fixation should be considered for stents at high risk for migration.Martins BC, Retes FA, Medrado BF, Lima MS, Pennacchi CMPS, Kawaguti FS, Safatle-Ribeiro AV, Uemura RS, MalufFilho F. Endoscopic management and prevention of migrated esophageal stents. World J Gastrointest Endosc 2014; 6(2): 49-54 Available from:

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Dislocated Atkinson tubes: removal and repositioning with a balloon catheter.

Cited by 6 publications

References 0 publications

Removal of Migrated Esophageal Stents in the Stomach Under the Guidance of Fluoroscopy: a Single-center Retrospective Study

Removal of Migrated Esophageal Stents in the Stomach Under the Guidance of Fluoroscopy: a Single-center Retrospective Study

Migrated Esophageal Stent Endoscopic Extraction through Gastrostomy Site in a Patient with Severe Esophageal Stricture

Endoscopic management and prevention of migrated esophageal stents

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