Fluoroscopic removal of fractured, retained, embedded Z self-expanding metal stent using a guidewire lasso technique: A case report

Figure 1 Examination before esophagectomy 21 mo ago. A: Esophagography showed that the tumor was located in the middle and lower part of the esophagus; B: A chest contrast-enhanced computed tomography scan showed thickened esophageal wall; C: Esophageal gastroscopy examination was performed and biopsy pathology confirmed esophageal squamous cell carcinoma.

Figure 2 Balloon dilation and stent removal performed 13. 5 mo after stenting. A: Esophagography showed severe stenosis (arrow) above the proximal stent; B: A 20 mm in diameter and 40 mm in length balloon catheter was introduced to dilate the stenotic segment; C: A stent removal sheath was introduced and then a removal hook (arrow) was placed in the lower part of the stent, stent fracture occurred and only one-third of the stent was retrieved; D: A 0.035-inch guidewire was introduced and passed over the remaining fractured stent and looped back from the stent to the mouth (arrow); E: A suction tube was introduced through the guidewire and then the guidewire was grabbed, acting like a “lasso” on tightening; F: The fractured stent was successfully removed and the strut was deformed (arrow).

Figure 3 Balloon dilation performed approximately 40 d after stent removal. A: Chest enhanced computed tomography examination showed obvious thickened esophageal wall (arrow); B: Esophagography showed severe stenosis (arrow) in the proximal part of the esophagus. C: A 28 mm in diameter and 40 mm in length big balloon catheter was used to dilate the stenotic section; D: Esophagography showed that the stenosis (arrow) disappeared after dilation.