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tion (3%–14%) following deployment of an esophageal self-expandable metallic stent (SEMS) [1]. Although removal of migrated SEMS in the stomach is recommended to avoid gastrointestinal complications such as bleeding, obstruction, and perforation, this can be technically challenging. A52-year-oldmanwas referred toourcenter for progressive dysphagia following a caustic injury, which was refractory to multiple balloon dilations carried out in the past two years. On esophagoscopy, a 3-mm stricture at 25 cm from the incisors could not be passed. A barium swallow showed another severe esophageal stricture at 34 cm (●" Fig. 1) from the incisors. A fully covered stent with internal and external silicone coating (Evolution, 10 cm, Cook Medical, Limerick, Ireland) was deployed under fluoroscopic guidance without complications. The patient improved notably after this procedure. At 1 month, endoscopy revealed that the stent had migrated. The esophageal caliber was significantly increased but resistance was encountered when passing a 9.2-mm endoscope across both stenoses (●" Fig. 1). The prosthesis was found to be located along the great curvature of the antrum, however, removal by grasping the nylon loop attached to the proximal end of the stent was not possible through the distal stricture (●" Fig. 2). Hence four detachable ligating devices (Polyloop, HX-400U-30, Olympus, Barcelona, Spain) were used to squeeze the SEMS and reduce its radial force (●" Fig. 3). This maneuver allowed the prosthesis to be easily removed through both strictures. At 6 months’ follow-up, the patient had gained 5 kg inweight andwas tolerating a solid diet. There are anecdotal reports of the usefulness of endoloops to extract migrated esophageal SEMS [2–4]. SEMSare currently indicated not only formalignant but also benign strictures, so it is anticipated that the number of SEMS being used and potentially migrating will increase [1]. Awareness of the technique described in this report will enhance the endoscopist’s armamentarium when faced with this complication.

Removal of a migrated covered metallic stent through an esophageal stricture, with multiple endoloops