Effectiveness of the Interventional Technique for the Removal of Self-Expanding Metallic Esophageal Stents Under Fluoroscopy

Abstract

Timely removal of esophageal stents can help avoid or reduce the occurrence of complications. This study was aimed at elucidating the interventional technique for the removal of self-expanding metallic esophageal stents (SEMESs) under fluoroscopy and analyzing its safety and efficacy. The medical records of patients who underwent removal of SEMESs by interventional techniques under fluoroscopy were retrospectively analyzed. Furthermore, the success and adverse event rates for different interventional techniques of stent removal were analyzed and compared. Overall, 411 patients were included, and 507 metallic esophageal stents were removed. There were 455 and 52 fully and partially covered SEMESs, respectively. According to the stent indwelling time, benign esophageal diseases were divided into two groups: ≤68 days and >68 days. There was a significant difference in the incidence of complications between the two groups (13.1% and 30.5%, respectively, p < .001). The stents in cases of malignant esophageal lesions were divided into the following two groups: ≤52 days and >52 days. Intergroup differences in complication incidence were not significant (p=.81) Further, there was a significant difference in removal time between the recovery line pull and proximal adduction techniques (4 and 6 minutes, respectively, p < .001). In addition, the recovery line pull technique was associated with a lower rate of complications (9.8% vs 19.1 %, p=.04). There was no statistical difference in the technical success rate and incidence of adverse events between the inversion and stent-in-stent techniques. Interventional technique to remove SEMESs under fluoroscopy is safe, effective, and worthy of clinical application.