[Percutaneous removal of displaced metal stents in TIPS]

Basing on our experience with three dislocated or displaced stents (one Wallstent, two Plamaz stents) during or after TIPS-procedure, we describe our technique to reposition or remove the stents.

The stents were moved back into the inferior vena cava by means of a balloon catheter, an alligator forceps, or an Amplatz gooseneck snare. They were secured against further dislocation by a central guidewire. After insertion of a balloon catheter into each dislocated stent, they were coaxially grasped with an Amplatz gooseneck snare. Stent diameter was reduced by forceful closure of the snare, and then the stent was either relocated or removed.

To prevent further stent migration it is necessary to remove the stent via a guidewire. By using a balloon catheter and a coaxially inserted Amplatz gooseneck snare, reduction of the outer stent diameter is possible even in Plamaz stents, facilitating their relocation or removal.