Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Thoracic Surgery,The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Acad Radiol. 2023 Oct;30(10):2192-2200. doi: 10.1016/j.acra.2022.11.029. Epub 2023 Mar 7.
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.
及时取出食管支架有助于避免或减少并发症的发生。本研究旨在阐明透视下经介入技术取出自膨式金属食管支架（SEMES）的方法，并分析其安全性和有效性。
回顾性分析了 411 例经透视下介入技术取出 SEMES 的患者的病历资料，并分析和比较了不同支架取出介入技术的成功率和不良事件发生率。
共纳入 411 例患者，共取出 507 枚金属食管支架，其中完全覆盖 SEMESs 455 枚，部分覆盖 SEMESs 52 枚。根据支架留置时间，良性食管疾病分为 68 天内和 68 天以上两组，两组并发症发生率差异有统计学意义（13.1%和 30.5%，P <.001）。恶性食管病变患者的支架分为 52 天内和 52 天以上两组，组间并发症发生率差异无统计学意义（P =.81）。进一步比较不同取出方法的差异，回收线提拉法和近端靠拢法的取出时间分别为 4 分钟和 6 分钟，差异有统计学意义（P <.001），回收线提拉法并发症发生率较低（9.8%比 19.1%，P =.04）。翻转法和支架内支架法的技术成功率和不良事件发生率差异无统计学意义。
透视下经介入技术取出 SEMES 是安全、有效的，值得临床应用。
