Eliminating Covered Self-Expanding Stent Migration with a Novel Fixation Procedure

Shanda H Blackmon, Assistant Professor. The Methodist Hospital

BACKGROUND: Leakage from esophageal and gastric perforation carries a high morbidity and often requires surgical intervention. In spite of the promising early results from esophageal stenting, migration of the stent continues to plague the physician, and occurs twenty to sixty percent of the time. A new technique to prevent migration of the stent is described.

METHODS: Ten patients presenting with leakage from esophageal or gastric perforation underwent stent fixation with a novel technique in a single institution from January 2008 to January 2011.

RESULTS: Five patients who previously presented with stent migration and required repositioning of the stent successfully has stent fixation with the temporary bridle technique. An additional five patients who were at high risk for stent migration had the new technique used and experienced successful anchor of the stent.

CONCLUSIONS: This novel technique of stent anchoring to prevent migration is both safe and effective when treating patients with benign leaks and fistulas of the foregut. Until non-migrating stents can be developed, such techniques will be required to prevent additional complications.