Stentmigration

Stent migration refers to the movement of an implanted stent away from its original position, which can lead to loss of its therapeutic effect and new complications. Stents are used in various luminal environments, including vascular, biliary, urinary, and airway passages, and migration can occur with any type of expandable or self-expanding device.

Migration can be proximal or distal relative to the initial deployment and may result from inadequate sizing, foreshortening, insufficient radial force, tissue ingrowth, or changes in anatomy and physiology such as peristalsis or respiration. Certain locations or stent designs are more prone to movement, and migration may occur soon after placement or weeks to months later.

Clinical presentation varies by location and may range from asymptomatic incidental findings to new or recurrent obstruction, pain, jaundice, cholangitis, chest pain, coughing up blood, or respiratory distress. Imaging studies such as X-ray, fluoroscopy, computed tomography, ultrasound, or endoscopic visualization are used to confirm stent position and determine any complications.

Management focuses on relocating or removing the migrated stent and treating any complications. Endoscopic retrieval with nets, baskets, or forceps is often attempted; repositioning or redeployment of the same or a new stent may be possible. If endoscopic methods fail or complications are present, surgical or interventional radiology approaches may be required. Preventive strategies include appropriate sizing and selection of stent type, secure anchoring designs, careful deployment technique, and consideration of anti-migration features in stent design.

Prognosis depends on the underlying reason for migration and the success of retrieval or replacement, as well as the absence of resulting complications.