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21.06.2016 | Interventional

Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system

verfasst von: Pyeong Hwa Kim, Ho-Young Song, Jung-Hoon Park, Wei-Zhong Zhou, Han Kyu Na, Young Chul Cho, Eun Jung Jun, Jun Ki Kim, Guk Bae Kim

Erschienen in: European Radiology | Ausgabe 3/2017

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Abstract

Objectives

To evaluate clinical outcomes of fluoroscopic removal of retrievable self-expandable metal stents (SEMSs) for malignant oesophageal strictures, to compare clinical outcomes of three different removal techniques, and to identify predictive factors of successful removal by the standard technique (primary technical success).

Methods

A total of 137 stents were removed from 128 patients with malignant oesophageal strictures. Primary overall technical success and removal-related complications were evaluated. Logistic regression models were constructed to identify predictive factors of primary technical success.

Results

Primary technical success rate was 78.8 % (108/137). Complications occurred in six (4.4 %) cases. Stent location in the upper oesophagus (P=0.004), stricture length over 8 cm (P=0.030), and proximal granulation tissue (P<0.001) were negative predictive factors of primary technical success. If granulation tissue was present at the proximal end, eversion technique was more frequently required (P=0.002).

Conclusions

Fluoroscopic removal of retrievable SEMSs for malignant oesophageal strictures using three different removal techniques appeared to be safe and easy. The standard technique is safe and effective in the majority of patients. The presence of proximal granulation tissue, stent location in the upper oesophagus, and stricture length over 8 cm were negative predictive factors for primary technical success by standard extraction and may require a modified removal technique.

Key Points

• Fluoroscopic retrievable SEMS removal is safe and effective.

• Standard removal technique by traction is effective in the majority of patients.

• Three negative predictive factors of primary technical success were identified.

• Caution should be exercised during the removal in those situations.

• Eversion technique is effective in cases of proximal granulation tissue.

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Titel: Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system
verfasst von: Pyeong Hwa Kim
Ho-Young Song
Jung-Hoon Park
Wei-Zhong Zhou
Han Kyu Na
Young Chul Cho
Eun Jung Jun
Jun Ki Kim
Guk Bae Kim
Publikationsdatum: 21.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4431-2

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Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system