Repositioning of a migrated esophageal stent using a retroflexed endoscope

Removal of esophageal expandable metal stents

“…There are previous reports describing the removal or repositioning of expandable metallic stents after migration [8,21,24] or inappropriate deployment [2]. Our technique is closest to that described by Mallery and Freeman [17], who removed an incompletely expanded Ultraflex stent with distal to proximal invagination into an overtube.…”

Modified technique to extract malpositioned or migrated self‐expanding stents from the esophagus and stomach

“…Various methods have been used traditionally to extract migrated or malpositioned SES from the upper gastrointestinal tract 3,4,7–14,18 . These have included using a retroflexed endoscope technique, an endoloop device, stent retrieval hook under fluoroscopic guidance, invagination of the SES with overtube assisted removal, combined lithotripsy basket and overtube, snare and rat tooth forceps combined with a double channel endoscope, snare with overtube impaction and the lasso technique.…”

“…Also, their use has increased in the management of difficult benign esophageal strictures 2 . Repeat intervention is occasionally required due to recurrent dysphagia, SES malposition or migration 3–18 . Extraction of a SES may be difficult with substantial risk of complication including esophageal perforation and hemorrhage.…”

“…The ability to remove a SES endoscopically is advantageous in the management of these situations. Multiple investigators have described various endoscopic extraction techniques from the upper gastrointestinal tract 3,4,7–14 . However, the reported techniques have provided minimal protection to the esophageal mucosa, along with the lower and upper esophageal sphincters, or used an overtube to provide esophageal mucosal protection.…”

Endoscopic removal of a migrated esophageal self-expandable metal stent after compression with detachable snares through an intact esophageal stent

“…1,2 Successful repositioning of migrated stents has been reported. 3,4 However, extraction of the migrated stent is advocated because it can cause hemorrhage, perforation, or bowel obstruction. 5 We report a case of easy endoscopic removal of a migrated esophageal SEMS after compression with detachable snares through another esophageal SEMS.…”