Stent-in-stent technique for removal of embedded partially covered self-expanding metal stents

Tomas DaVee, Shayan Irani, Cadman L. Leggett, Manuel Berzosa Corella, Karina V. Grooteman, Louis Michel Wong Kee Song, Michael B. Wallace, Richard A. Kozarek, Todd H. Baron

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: Removal of embedded partially covered self-expanding metal stents (PCSEMS) is associated with an increased risk of adverse events compared with removal of fully covered self-expanding stents (FCSES) due to tissue ingrowth. Successful removal of embedded PCSEMS has been described by the stent-in-stent (SIS) technique. Aims: To report the first US experience from three high-volume quaternary care centers on the safety and efficacy of the SIS technique for removal of embedded PCSEMS. Methods: Retrospective study of outcomes for consecutive patients who underwent the SIS for removal of embedded PCSEMS over a 5-year period. Results: Twenty-seven embedded PCSEMS were successfully removed using the SIS technique (100 %) from 25 patients (11 males), median age 65 (range 37–80). All stents were successfully removed in one endoscopic session (no repeat SIS procedures were required for persistently embedded stents). The embedded PCSEMS had been in situ for a median of 76 days (range 26–501). Median SIS dwell time (FCSES in situ of PCSEMS) was 13 days (interquartile range 8–16 days; range 4–212 days). One adverse event (self-limited bleeding) occurred during a median follow-up period of 3 months (range 1–32). No patients died, required surgery, or had long-term disability due to adverse events attributed to the SIS technique. Twelve patients required additional interventions following SIS procedure for persistence or recurrence of the underlying pathology. Conclusion: When performed by experienced endoscopists, safe and effective removal of embedded PCSEMS can be achieved via the SIS technique.

Original languageEnglish (US)
Pages (from-to)2332-2341
Number of pages10
JournalSurgical endoscopy
Volume30
Issue number6
DOIs
StatePublished - Jun 1 2016

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Keywords

  • Advanced therapeutic endoscopy
  • Anastomotic perforation or leak
  • Embedded stents
  • Endoscopic stents
  • Esophageal cancer
  • Esophageal strictures

ASJC Scopus subject areas

  • Surgery

Cite this

DaVee, T., Irani, S., Leggett, C. L., Berzosa Corella, M., Grooteman, K. V., Wong Kee Song, L. M., Wallace, M. B., Kozarek, R. A., & Baron, T. H. (2016). Stent-in-stent technique for removal of embedded partially covered self-expanding metal stents. Surgical endoscopy, 30(6), 2332-2341. https://doi.org/10.1007/s00464-015-4475-4