Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2516
Peer-review started: July 25, 2021
First decision: October 25, 2021
Revised: November 25, 2021
Accepted: January 29, 2021
Article in press: January 29, 2022
Published online: March 16, 2022
There are few reports of a fractured esophageal self-expanding metallic stent (SEMS) and the lasso retrieval technique, forming a guidewire loop by directing the guidewire back up the external stent for retrieval.
A 74-year-old man complained of dysphagia approximately 6 mo after radical resection of esophageal cancer. Benign anastomotic stenosis was diagnosed, and a 20 mm in diameter and 60 mm in length esophageal covered SEMS was inserted after repeated balloon dilatation. About 13.5 mo after stenting, dysphagia recurred and esophagography showed severe stenosis above the proximal stent and stent removal was performed. One-third of the stent was removed and the fractured stent remained in the proximal esophagus. A suction tube was introduced through the guidewire and then the guidewire was grabbed, acting like a “lasso” on tightening. The remaining fractured stent was successfully removed by slowly pulling back the guidewire, with no fragments of stent wires retained.
The guidewire lasso technique is a simple, effective method of removing esophageal SEMS in rare cases of stent fracture.
Core Tip: We present a case in which the guidewire lasso technique was used to remove a fractured esophageal Z-stent. A 74-year-old man developed dysphagia approximately 6 mo after resection for esophageal cancer and a Z stent was inserted. After 13.5 mo, esophagography showed severe stenosis above the proximal stent. One-third of the stent was removed and the fractured stent remained in the proximal esophagus. A suction tube was introduced through the guidewire and then the guidewire was grabbed, acting like a “lasso” on tightening. The fractured stent was successfully removed by slowly pulling back the guidewire, with no fragments of stent wires retained.