Bi Yong-Hua, Ren Jian-Zhuang, Li Jin-Dong, Han Xin-Wei
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
World J Clin Cases. 2022 Mar 16;10(8):2516-2521. doi: 10.12998/wjcc.v10.i8.2516.
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.
关于食管自膨式金属支架（SEMS）断裂及套索回收技术（通过将导丝沿外部支架向上引导形成导丝环以进行回收）的报道较少。
一名74岁男性在食管癌根治性切除术后约6个月出现吞咽困难。诊断为良性吻合口狭窄，在反复球囊扩张后插入了直径20mm、长度60mm的食管覆膜SEMS。支架置入约13.5个月后，吞咽困难复发，食管造影显示近端支架上方严重狭窄，遂进行支架取出。取出了三分之一的支架，断裂的支架仍留在食管近端。通过导丝插入一根吸引管，然后抓住导丝，收紧时其作用类似于“套索”。通过缓慢回撤导丝成功取出了剩余的断裂支架，没有残留支架丝碎片。
在罕见的支架断裂情况下，导丝套索技术是一种简单、有效的取出食管SEMS的方法。
