Endoscopic laser fragmentation and removal of a nonremovable metal esophageal stent for persistent dysphagia: a technical note.

ABSTRACT

BACKGROUND: Self-expanding metal stents are widely used in the palliation of esophageal diseases (Todd, N Engl J Med 344(22)1681-1687, 2001). The majority are inserted for end-stage malignancy and are not designed to be removed. METHODS: We report the first recorded successful endoscopic removal of an "irremovable" stent by laser fragmentation after its placement became redundant. A 72-year-old man who had persistent dysphagia after esophageal stent insertion for Boerhaave's syndrome had his stent removed by Nd-YAG laser fragmentation at staged endoscopies. RESULTS: The stent was removed in its entirety and the patients' symptoms resolved. CONCLUSIONS: We describe a successful technique for the removal of a nonretrievable stent using laser fracture and endoscopic retrieval. This method of stent removal has not been previously reported.