Novel mechanical debridement technique to assist in removal of deeply embedded degenerated esophageal metal stent: a case report.

Embedment of a self-expandable metal stent (SEMS) is a rare but serious adverse event, often due to granulation tissue overgrowth, with prolonged dwell time being a major risk factor. An 18-year-old girl with a history of corrosive esophageal stricture and SEMS placement 26 months earlier presented with progressive dysphagia. Endoscopy revealed a completely embedded stent with distal stenosis. Initial management with stent-in-stent technique using fully covered SEMSs and argon plasma coagulation (APC) failed to achieve tissue necrosis. Mechanical debridement was, therefore, undertaken using a novel approach with standard endoscopic accessories, given the unavailability of specialized devices. Circumferential APC was followed by superficial tissue scraping with biopsy forceps and deeper debridement with a distal attachment cap. After 2 sessions, the stent was fully exposed and removed safely. This case highlights that mechanical debridement with routine endoscopic tools can provide a safe, effective, and accessible solution for deeply embedded esophageal stents.