Endoscopic management and prevention of migrated esophageal stents

Figure 1 Endoscopic removal. A: Rat-toothed grasper inside the biliary stent pusher; B: Stent border constrained by the grasper and pusher together.

Figure 2 The Niti-S stent has a double-layered configuration. The inner covered layer protects against tumor ingrowth and the additional uncovered mesh helps to resist migration.

Figure 3 A length of dental floss or equivalent thread is grasped with a biopsy forceps and passed through the working channel of a standard endoscope. A: The dental floss is grasped with a biopsy forceps; B: The dental floss is passed through the stent mesh from the outside to the inside and carried down using the biopsy forceps; C: The dental floss is inserted into a nasoenteral tube, which is pushed down towards the mesh to protect the nasopharyngeal mucosa.

Figure 4 Endoscopic clips may be applied at the upper border of the stent to prevent migration.