Clinical Endoscopy

A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study: Arata Sakai, Atsuhiro Masuda, Takaaki Eguchi, Keisuke Furumatsu, Takao Iemoto, Shiei Yoshida, Yoshihiro Okabe, Kodai Yamanaka, Ikuya Miki, Saori Kakuyama, Yosuke Yagi, Daisuke Shirasaka, Shinya Kohashi, Takashi Kobayashi, Hideyuki Shiomi, Yuzo Kodama; Clin Endosc 2024;57(3):375-383. Published online July 10, 2023; DOI: https://doi.org/10.5946/ce.2023.035

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Background
/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO.
Methods
This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events.
Results
A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration.
Conclusions
The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.

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Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
Sung-Jo Bang
Clinical Endoscopy.2024; 57(1): 56. CrossRef
Understanding mechanical properties of biliary metal stents for wise stent selection
Seok Jeong
Clinical Endoscopy.2023; 56(5): 592. CrossRef

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A Rare Case of Coil Migration into the Duodenum after Embolization of a Right Colic Artery Pseudoaneurysm: Jeongmin Choi, Young Moon Kim; Clin Endosc 2021;54(6):920-923. Published online January 12, 2021; DOI: https://doi.org/10.5946/ce.2020.228

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Transcatheter arterial embolization is a safe and effective treatment for visceral artery aneurysms; nevertheless, some complications can occur. Coil migration to other organs after embolization is extremely rare, and only 16 cases have been reported previously. We report a rare case of coil migration to the duodenal lumen after embolization of a right colic artery pseudoaneurysm. To the best of our knowledge, this is the first case of coil migration after a right colic artery embolization. The patient exhibited no symptoms and was treated conservatively without any intervention. Some previous reports have demonstrated spontaneous coil passage and successful conservative management. Our case supports conservative treatment as the primary treatment for asymptomatic patients. Clinicians should assess the risks and benefits of coil removal in asymptomatic patients before performing any intervention.

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Case report: Duodenal obstruction caused by gastroduodenal artery pseudoaneurysm with hematoma: an unusual case and literature review
Yan-Yuan Zhou, Shao-Chung Wang, Chen-June Seak, Shu-Wei Huang, Hao-Tsai Cheng
Frontiers in Medicine.2023;[Epub] CrossRef
Assessing the aneurysm occlusion efficacy of a shear-thinning biomaterial in a 3D-printed model
Grant Schroeder, Masoud Edalati, Gregory Tom, Nicole Kuntjoro, Mark Gutin, Melvin Gurian, Edoardo Cuniberto, Elisabeth Hirth, Alessia Martiri, Maria Teresa Sposato, Selda Aminzadeh, James Eichenbaum, Parvin Alizadeh, Avijit Baidya, Reihaneh Haghniaz, Roho
Journal of the Mechanical Behavior of Biomedical Materials.2022; 130: 105156. CrossRef
A case of coil migration into the colon after embolization of the spleno-renal shunt
Tomomi Sadamitsu, Fumikazu Koyama, Toshihiro Tanaka, Hiroyuki Kuge, Masayuki Sho
Techniques in Coloproctology.2022; 26(11): 923. CrossRef

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Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel: Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim; Clin Endosc 2019;52(6):612-615. Published online May 20, 2019; DOI: https://doi.org/10.5946/ce.2019.020

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Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.

Citations

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Pulsation of visible vessel or adherent clot in duodenal ulcer may indicate pseudoaneurysm: Case series
Jiayu Ju, Ziyao Cheng, Qingliang Zhu, Mingming Deng, Hailong Zhang
Medicine.2023; 102(5): e32819. CrossRef
Rare but critical: Aberrant vascular communication leading to multiorgan ischemia after prophylactic gastroduodenal artery embolization for refractory upper gastrointestinal bleeding
Muhammad Ibrahim Saeed, Amna Subhan Butt, Jahanzeb Shahid, Junaid Iqbal
Radiology Case Reports.2023; 18(11): 3926. CrossRef
Gastric Bleeding Caused by Migrated Coil: A Rare Complication of Splenic Artery Coil Embolization
Tian Li, Bayan Alsuleiman, Manuel Martinez
Gastro Hep Advances.2022; 1(1): 67. CrossRef
Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer
Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning
Cureus.2021;[Epub] CrossRef
Management of Gastroduodenal Artery Pseudoaneurysm Rupture With Duodenal Ulcer Complicated by Coil Migration
Dennis Chang, Purvi Patel, Seth Persky, Joseph Ng, Alan Kaell
ACG Case Reports Journal.2020; 7(4): e00347. CrossRef
Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report
Andrzej Żyluk, Samir Zeair, Janusz Kordowski, Ewa Gabrysz-Trybek
Polish Journal of Surgery.2020; 93(SUPLEMENT): 54. CrossRef

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Endoscopic Removal of a Migrated Coil after Embolization of a Splenic Pseudoaneurysm: A Case Report: Yoo Min Han, Jong Yeul Lee, Il Ju Choi, Chan Gyoo Kim, Soo-Jeong Cho, Jun Ho Lee, Hyun Beom Kim, Ji Min Choi; Clin Endosc 2014;47(2):183-187. Published online March 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.2.183

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Splenic artery pseudoaneurysms can be caused by pancreatitis, trauma, or operation. Traditionally, the condition has been managed through surgery; however, nowadays, transcatheter arterial embolization is performed safely and effectively. Nevertheless, several complications of pseudoaneurysm embolization have been reported, including coil migration. Herein, we report a case of migration of the coil into the jejunal lumen after transcatheter arterial embolization of a splenic artery pseudoaneurysm. The migrated coil was successfully removed by performing endoscopic intervention.

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Successful peroral cholangioscopic extraction of migrated endovascular coils into the bile ducts 2 years following right hepatic artery pseudoaneurysm endovascular treatment
Landry Hakiza, Lucien Widmer, Ken Liu, Cyrille Frei, Konstantin Burgmann, Frank Seibold, Christoph Matter, Dominic Staudenmann
VideoGIE.2024; 9(8): 379. CrossRef
Development of an Injectable, ECM-Derivative Embolic for the Treatment of Cerebral Saccular Aneurysms
Seungil Kim, Kamil W. Nowicki, Keishi Kohyama, Aditya Mittal, Sangho Ye, Kai Wang, Taro Fujii, Shivbaskar Rajesh, Catherine Cao, Rohit Mantena, Marianna Barbuto, Youngmee Jung, Bradley A. Gross, Robert M. Friedlander, William R. Wagner
Biomacromolecules.2024; 25(8): 4879. CrossRef
Gastric Bleeding Caused by Migrated Coil: A Rare Complication of Splenic Artery Coil Embolization
Tian Li, Bayan Alsuleiman, Manuel Martinez
Gastro Hep Advances.2022; 1(1): 67. CrossRef
Down to the Wire: A Case of Gastrointestinal Bleeding After Splenic Artery Coiling
John P. Haydek, Augustin R. Attwell
ACG Case Reports Journal.2022; 9(7): e00835. CrossRef
Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer
Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning
Cureus.2021;[Epub] CrossRef
Wire from the major papilla: Migration of endovascular coil into the main pancreatic duct
Sho Kitagawa, Shori Ishikawa, Hiroyuki Miyakawa
Digestive Endoscopy.2021;[Epub] CrossRef
Injectable hydrogels for vascular embolization and cell delivery: The potential for advances in cerebral aneurysm treatment
Seungil Kim, Kamil W. Nowicki, Bradley A. Gross, William R. Wagner
Biomaterials.2021; 277: 121109. CrossRef
A Rare Case of Coil Migration into the Duodenum after Embolization of a Right Colic Artery Pseudoaneurysm
Jeongmin Choi, Young Moon Kim
Clinical Endoscopy.2021; 54(6): 920. CrossRef
Embolization coil migration in the stomach and spontaneous excretion: a case report and review of the literature
Yasuo Matsubara, Lay Ahyoung Lim, Yasuki Hijikata, Yoshihiro Hirata, Hiroshi Yotsuyanagi
Radiology Case Reports.2020; 15(7): 1018. CrossRef
Migration of Gastric Varix Coil After Balloon-Occluded Antegrade Transvenous Obliteration
Antoinette J. Pusateri, Mina S. Makary, Khalid Mumtaz
ACG Case Reports Journal.2020; 7(10): e00472. CrossRef
Clinical Outcome of the Visible Coil During Endoscopy After Transcatheter Arterial Embolization for Gastrointestinal Bleeding
Jong-Joon Shim, Hee Ho Chu, Ji Hoon Shin, Jong Woo Kim, Do Hoon Kim, Hwoon-Yong Jung, Ji Yong Ahn
CardioVascular and Interventional Radiology.2019; 42(11): 1537. CrossRef
Migrated embolization coil causes intestinal obstruction
W. Preston Hewgley, David L. Webb, H. Edward Garrett
Journal of Vascular Surgery Cases, Innovations and Techniques.2018; 4(1): 8. CrossRef
Laparoscopic endoscopic combined surgery for removal of migrated coil after embolization of ruptured splenic artery aneurysm
Akshay Pratap, Bhavani Pokala, Luciano M Vargas, Dmitry Oleynikov, Vishal Kothari
Journal of Surgical Case Reports.2018;[Epub] CrossRef
Coil Migration to the Duodenum 1 Year Following Embolisation of a Ruptured Giant Common Hepatic Artery Aneurysm
Yoshikatsu Nomura, Yasuko Gotake, Takuya Okada, Masato Yamaguchi, Koji Sugimoto, Yutaka Okita
EJVES Short Reports.2018; 39: 33. CrossRef
Surgical Removal of Migrated Coil after Embolization of Jejunal Variceal Bleeding: A Case Report
Junhwan Kim, Danbi Lee, Kyunghwan Oh, Mingee Lee, Seol So, Dong-Hoon Yang, Chan-Wook Kim, Dong Il Gwon, Young-Hwa Chung
The Korean Journal of Gastroenterology.2017; 69(1): 74. CrossRef
Vascular coil erosion into hepaticojejunostomy following hepatic arterial embolisation
Soondoos Raashed, Manju D Chandrasegaram, Khaled Alsaleh, Glen Schlaphoff, Neil D Merrett
BMC Surgery.2015;[Epub] CrossRef

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Esophageal Stent for Cervical Esophagus and Esophagogastric Junction: Chan Sup Shim; Clin Endosc 2012;45(3):235-239. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.235

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Tumors in the cervical portion of the esophagus have traditionally been more difficult to manage. The implantation in the cervical esophagus is a technically demanding procedure. The implantation of modified self-expandable metal stents (SEMSs) was very effective perorally under endoscopic and fluoroscopic guidance. Experience with SEMS has revealed an increased risk of migration when either covered stents are used or a stent is implanted across the gastroesophageal junction. The modified, covered, esophageal stents appear to prevent stent migration and improve dysphagia in patients with malignant tumor stenosis at the esophagogastric junction. Besides heartburn, regurgitation is sometimes very distressing to patients and may lead to fatal aspiration due to reflux after stenting in esophagogastric junction. These symptoms can be reduced by the use of valved stent. The long S-shape valve is very effective in preventing acid reflux and valve inversion.

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Hydrogel‐Impregnated Robust Interlocking Nano Connector (HiRINC) for Noninvasive Anti‐Migration of Esophageal Stent
Eunyoung Jeon, Song Hee Kim, Sukyoung Kim, Dae Sung Ryu, Ji Won Kim, Kayoung Kim, Do Hoon Kim, Jung‐Hoon Park, Joonseok Lee
Advanced Materials.2025;[Epub] CrossRef
Endoscopic management of upper gastrointestinal perforations, leakage and fistula
Hee Seok Moon
Journal of Innovative Medical Technology.2023; 1(1): 15. CrossRef
How much progress have we made?: a 20-year experience regarding esophageal stents for the palliation of malignant dysphagia
Shria Kumar, Firas Bahdi, Ikenna K Emelogu, Abraham C Yu, Martin Coronel, Philip S Ge, Emmanuel Coronel, Jaffer A Ajani, Brian Weston, Patrick Lynch, William A Ross, Jeffrey H Lee
Diseases of the Esophagus.2022;[Epub] CrossRef
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Luiza L. Ramos, Ravi C. Marques, Hugo G. Guedes
Obesity Surgery.2022; 32(5): 1761. CrossRef
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Joel Ferreira-Silva, Eduardo Rodrigues-Pinto, Filipe Vilas-Boas, Guilherme Macedo
Endoscopy.2022; 54(S 02): E904. CrossRef
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Abhijith Bale, Irshad H Ali, Ajay Bale, Vidyasagar Ramappa, Umesh Jalihal
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Amanda Rabone, Bhavin Kawa, Benedict Thomson, Sarah Kemp, Claire Elwood, Abuchi Okaro, Mark Hill, Timothy Sevitt, Justin Waters, Paul Ignotus, Aidan Shaw
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Chang-Il Kwon, Jong Pil Moon, Ho Yun, Seok Jeong, Dong Hee Koh, Woo Jung Lee, Kwang Hyun Ko, Dae Hwan Kang
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Biomolecular and Health Science Journal.2018; 1(1): 52. CrossRef
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Laurent Poincloux, Camille Sautel, Olivier Rouquette, Bruno Pereira, Marion Goutte, Gilles Bommelaer, Michel Dapoigny, Armand Abergel
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Migration of a Biliary Self-Expanding Metal Stent into the Stomach after Stent Placement in a Patient with Periampullary Cancer: Sung Ho Ki, M.D., Seok Jeong, M.D., Don Haeng Lee, M.D.*, Jung Il Lee, M.D., Jin-Woo Lee, M.D., Hyung Gil Kim, M.D., Yong Woon Shin, M.D. and Young Soo Kim, M.D.; Korean J Gastrointest Endosc 2008;36(5):324-327. Published online May 30, 2008

Abstract PDF: Migration of a biliary self-expanding metallic stent (SEMS) may occur proximally or distally after placing a stent for the palliative treatment of patients with unresectable periampullary malignancy. However, migration of a biliary SEMS into the stomach has not yet reported in the English medical literature. Herein we report on a case of periampullary cancer for which a stent that was placed to treat this malady migrated into the stomach. A biliary SEMS had been placed in the distal common bile duct in an 82-year-old woman who was diagnosed with periampullary cancer. The abdominal CT and esophagogastroduodenoscopic findings disclosed that the biliary SEMS had migrated into the stomach and there was marked luminal narrowing of the second portion of the duodenum due to the enlarged periampullary tumor. The migrated stent was easily removed by using a polypectomy snare. We presume that the distally migrated SEMS might have moved into the stomach against the normal direction of peristaltic movement instead of migrating to the intestine because of the duodenal obstruction caused by the growing mass. (Korean J Gastrointest Endosc 2008;36:324-328)

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Endoscopic Retrieval of a Proximally Migrated Stent in the Dorsal Duct of Pancreas Divisum: Chul Sung Park, M.D., Jong Hyeok Kim, M.D., Na Rae Joo, M.D., Chin Woo Kwon, M.D., Hae Geun Song, M.D., Joon Ho Moon, M.D., Jae One Jung, M.D., Woon Geon Shin, M.D., Jong Pyo Kim, M.D., Kyoung Oh Kim, M.D., Cheol Hee Park, M.D., Taeho Hahn, M.D., Kyo-Sang; Korean J Gastrointest Endosc 2006;33(1):58-61. Published online July 30, 2006

Abstract PDF: Endoscopic treatment of chronic pancreatitis by stent insertion is an accepted procedure, but various complications can be induced, including proximal migration of the stent. Many techniques are used to retrieve proximally migrated, pancreatic stents. We here report a case of a proximally migrated stent into the dorsal duct of a pancreas divisum, which was retrieved endoscopically by using a mini-snare. A 39-year-old female patient had chronic pancreatitis with divisum. A stent was inserted into the dorsal duct to relieve the chronic pain. After two months, sudden epigastric pain developed due to proximal migration of the stent. The pancreatic stent was retrieved successfully with one endoscopic attempt using a mini- snare. The epigastric pain resolved after retrieval of the stent. Our observation is that pancreatic stent migration may cause severe abdominal pain and that endoscopic retrieval is possible. (Korean J Gastrointest Endosc 2006;33:58⁣62)

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A Case of Sigmoid Colonic Perforation due to Migration of a Plastic Stent for Endoscopic Retrograde Biliary Drainage: Hyun Sweung Jeong, M.D., Sang Jong Park, M.D., IL Dong Kim, M.D.*, Sang Bae Lee, M.D., Jin Kwang Lee, M.D. and Hoi Jin Kim, M.D.; Korean J Gastrointest Endosc 2004;28(3):156-160. Published online March 31, 2004

Abstract PDF: Placement of an endoprosthesis for billiary obstruction has been advocated as an effective alternative for internal- external drainage catheters or surgical procedure. Endoscopic retrograde biliary drainage (ERBD) is a method of transpapillary insertion and placement of drainage tube in the billiary tree under the direct view of endoscope. Early complications following ERBD that develop within 4 weeks include obstruction of the stent, cholangitis, hemorrhage, acute pancreatitis, and bile duct or duodenal perforation. Late complications include obstruction of the stent and cholangitis, migration of the stent, and intestinal perforation. We expierenced a case of sigmoid colonic perforation following ERBD in a patient with multiple biliary tract stone and cholangitis. Thus we report this case with a brief review of the literature. (Korean J Gastrointest Endosc 2004;28:156⁣160)

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Migration of Pyloric Self-Expanding Metallic Stent to the Esophagus: Young Gyun Kim, M.D., Jun Pyo Chung, M.D., Seung Hyun Cho, M.D., Seoung Joon Hwang, M.D., Dok Yong Lee, M.D., Sang Won Ji, M.D., Yong-Han Paik, M.D., Se Joon Lee, M.D., Byung Soo Moon, M.D., Kwan Sik Lee, M.D., Sang In Lee, M.D. and Jin Kyung Kang, M.D.; Korean J Gastrointest Endosc 2003;27(2):80-83. Published online August 30, 2003

Abstract PDF: Self-expandable metallic stent (SEMS) has been reported to provide effective treatment alternatives with minimal morbidity for patients with malignant gastroduodenal obstruction. Limitations of SEMSs are stent occlusion due to tumor ingrowth or overgrowth and stent migration. Migrated stents may remain in the stomach or travel distally. To our knowledge, however, migration of pyloric SEMS to the esophagus has not been reported. We experienced such a case in a 65-year-old woman who had undergone a gastrojejunostomy and choledochojejunostomy due to unresectable pancreatic head cancer. Pyloric SEMSs (Niti-S Pyloric Bare Stent, 18⁓60 mm, Taewoong Medical, Korea) were deployed at the obstructed efferent and afferent loops. After severe vomiting, a pyloric SEMS placed at the afferent loop migrated into the esophagus, which caused severe chest pain and intractable hiccup. It was removed endoscopically. This case illustrates that pyloric SEMS can migrate to the esophagus through the lower esophageal sphincter. (Korean J Gastrointest Endosc 2003;27:80⁣83)

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대장내시경으로 진단된 결장 내 수술 스펀지 1 예 ( A Case of a Retained Surgical Sponge Diagnosed by Colonoscopy ): Korean J Gastrointest Endosc 2001;23(6):515-519. Published online November 30, 2000

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인공식도관 일탈 방지를 위해 새로 고안한 막 부착형 금속형 인공식도관의 유용성 ( A Prospective Clinical Trial of the Newly Designed Esophageal Covered Metal Stent for Prevention of Stent Migration ): Korean J Gastrointest Endosc 1999;19(5):700-705. Published online November 30, 1998

Abstract PDF: Background
/Aims: Palliation of malignant esophageal obstructions consists mainly of symptomatic treatment of dysphagia. For this purpose, variable self expandable esophageal stents have recently been used. Of these stents, membrane covered self expandable metal stents (SEMS) are effective to prevent tumor ingrowth and stent obstruction. But migration is the main problem of covered SEMS. So we made a newly designed covered SEMS for the prevention of stent migration and studied prospectively to define its palliative ability and whether this stent is effective for prevention of migration problems. Methods: From January to December 1998, 27 patients [23 men, 4 women; mean age 60 years, range 20 to 80] were inserted with newly designed esophageal stents and studied. Data analysis included the location and length of malignant strictures, the length of the inserted esophageal stents, the time for fixation of the stents after insertion, complications related to stent insertion, and the effectiveness of the newly designed stent for prevention of the stent migration. Results: 1) The location of esophageal strictures were 4 in the mid- esophagus (three tracheo-esophageal fistula due to two lung and one esophageal cancer, one esophageal cancer), 7 in the distal esophagus (all esophageal cancer), and 16 in the esophagogastric junction (6 cases of esophageal cancer, 9 with gastric cardiac cancer, and 1 with gastric lymphoma). 2) The mean length of the strictures was 5.2 (3 to 12) cm. 3) The mean length of the stents was 11 (8 to 16) cm. 4) Time for fixation of the stents was 7.2 (5 to 13) days after the stent insertion. 5) Stent placement was successful in all patients without any serious stent-related complications such as esophageal perforation or hemorrhage. During the mean follow-up period of 6 (1 to 12) months, there was no stent migration. Conclusions: The newly designed covered SEMS was very effective in preventing stent migration without any serious stent-related complications, especially in malignant strictures of the esophagogastric junction, short segment strictures, and T-E fistulas without tumor shoulder. (Korean J Gastrointest Endosc 19: 700∼705, 1999)

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위나 직장으로 미입된 EsophaCoil TM 배액관의 새로운 내시경적 제거술에 대한 고찰 ( Clicical Evaluation of a Novel Method for Endoscopic Removal of an EsophaCoil TM Stent which Migrated into the Stomach and Rectum ): Korean J Gastrointest Endosc 1999;19(4):531-536. Published online November 30, 1998

Abstract PDF: Background
/Aims: The coiled stent is designed to allow removal in the event that stent malposition or migration occurs in patients with an inoperable malignant esophageal obstruction. There is limited published material on the EsophaCoilTM, especially with regard to its removability. A novel method for endoscopic removal of migrated EsophaCoilTM prosthesis is herein described. Methods: Seven instances of migration occurred in 19 patients who had undergone coiled stent placement for carcinoma of the distal esophagus or gastric cardia. The stents had migrated into the stomach in 6 cases and the stent was at the rectosigmoid junction in 1 patient. The migrated stents were removed endoscopically using a conventional method in 3 cases, and the Song's stent introducer with a metal tip and overtube under fluoroscopic guidance, in the remaining 4 patients. Results: Using the new endoscopic removal technique, migrated stents were successfully removed in 4 patients after conventional methods failed. There were no complications. Conclusions: An EsophaCoilTM stent, migrating into the stomach or rectum, could be removed easily by this new method using the overtube and Song's stent introducer. (Korean J Gastrointest Endosc 19: 531∼536, 1999)

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