A novel fixation procedure to eliminate covered self-expanding metal stent migration

Leakage from esophageal and gastric perforation carries a high morbidity rate and requires surgical or endoscopic intervention. When stenting is utilized, migration of the stent is a common complication. A novel technique to prevent migration of the stent is described. Fourteen patients presenting with leakage from the foregut underwent stent fixation with this technique. A bridle is created by delivering umbilical tape through each nostril securing the stent for 4 days. None of the 14 patients' X-rays showed migration of the stent. This new technique is both safe and effective when treating leaks and perforations from the foregut. Until nonmigrating stents can be developed, such techniques will be an important resource for treatment.