Trimming a metallic biliary stent using an argon plasma coagulator.

BACKGROUND

Distal migration is one of the common complications after insertion of a covered metallic stent. Stent repositioning or removal is not always possible in every patient. Therefore, trimming using an argon plasma coagulator (APC) may be a good alternative method to solve this problem.

METHODS

Metallic stent trimming by APC was performed in 2 patients with biliary Wallstent migration and in another patient with esophageal Ultraflex stent migration. The power setting was 60-100 watts with an argon flow of 0.8 l/min.

OBSERVATIONS: The procedure was successfully performed and all distal parts of the stents were removed. No significant collateral damage to the nearby mucosa was observed.

CONCLUSIONS

In a patient with a distally migrated metallic stent, trimming of the stent is possible by means of an APC. This new method may be applicable to other sites of metallic stent migration.