Cryotechnology for staged removal of self-expandable metallic airway stents

Self-expandable covered metallic airway stents (SEMAS) deployed for relieving inoperable central airway obstruction frequently develop complications that require removal of the device. Current techniques for SEMAS removal also involve serious complications. We are reporting a novel two-staged endoscopic approach using cryotechnology for removal of SEMAS obstructed by exuberant granulation tissue in two patients. During the first stage, the obstructing intraluminal granulation tissue was removed with cryodebridement and residual extraluminal deposits were lysed with cryotherapy. During the second stage, performed two days later, the SEMAS was liberated by mechanical means and removed in one piece. The staged approach with cryotechnology was successful and without complications.