Slipped Flamingo Stent - treated with a high second stent

An elderly female patient with a tumour at the level of the aortic arch was treated with an (internally covered)10 cm Flamingo Wallstent. This migrated in the days after the inertion and the patient re-presented with complete dysphagia. It was feared that a second stent, overlapping the existing stent proximally, would be too high and impinge on the back of the pharynx.

With the patient supine on the fluoroscopy table, an endoscope was passed and a marker placed at the level of the cricopharyngeus. A guidewire was then advanced through the existing stent and checked fluoroscopically. A second stent, on this occasion a Microvasive Ultraflex 15cm, was inserted through the existing stent with the cup of the stent at the level of the cricopharyngeus.

The closeup view shows the stent is riding quite high almost within the pharyngeus. Though the patient initially complained of a "mild feeling in the back of the throat", this settled after 24 hours and she was not aware of the stent. I suspect the sensation she noticed was due to handling and abrasion of the pharynx from the scope and the stent and was similar to that reported by most stent or dilatation patients. She was able to tolerate a soft diet after 24 hours.