Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2516-2521
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2516
Fluoroscopic removal of fractured, retained, embedded Z self-expanding metal stent using a guidewire lasso technique: A case report
Yong-Hua Bi, Jian-Zhuang Ren, Jin-Dong Li, Xin-Wei Han
Yong-Hua Bi, Jian-Zhuang Ren, Xin-Wei Han, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Jin-Dong Li, Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Bi YH, Li JD, Han XW, and Ren JZ designed the study; Bi YH and Ren JZ performed the study; Ren JZ collected and analyzed data; all authors wrote the paper and finally approved the version to be published.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Wei Han, MD, PhD, Chief Doctor, Professor, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jian She Road, Zhengzhou 450052, Henan Province, China. dreamweaver08@126.com
Received: July 25, 2021
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
Processing time: 228 Days and 11.2 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

The guidewire lasso technique is a simple, effective method of removing esophageal SEMS in rare cases of stent fracture.

Keywords: Self-expanding metallic stent; Stenosis, Guidewire lasso technique; Stent removal; Esophagus; Case report

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.