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Quaretti P, Corti R, D’Agostino AM, Cionfoli N. U-bent Viabahn stent graft in the main left pulmonary artery in a hemodialysis patient after asymptomatic migration: Percutaneous removal and technical considerations. J Vasc Access 2024; 25:1666-1671. [PMID: 37439244 PMCID: PMC11402257 DOI: 10.1177/11297298231158545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/02/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Stent grafts (SG) have gained the highest level of evidence for superior management over angioplasty of arteriovenous graft (AVG) venous outflow stenosis, which increases their use in hemodialysis patients. Migration to the heart and lungs is the most feared complication of SG of the venous system. METHOD We present a previously unreported case of asymptomatic migration of a 10-cm-long Viabahn lodged in a U-shaped configuration in the main left pulmonary artery after AVG intervention in a 50 year old male hemodialysis patient. RESULTS Through a single femoral access percutaneous retrieval of migrated SG was accomplished. Technique of coaxial buddy snaring technique is described. CONCLUSION Our technique may expand the endovascular likelihood of successful stent removal.
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Affiliation(s)
- Pietro Quaretti
- Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Corti
- Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Nicola Cionfoli
- Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Cizman Z, Zachery Paden W, Smith T, Wilhite S, Strain D, Saad W. Endovascular retrieval of a migrated covered stent from the pulmonary artery. Radiol Case Rep 2024; 19:2117-2120. [PMID: 38645538 PMCID: PMC11026935 DOI: 10.1016/j.radcr.2024.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 04/23/2024] Open
Abstract
Stent migration is a rare but significant complication following endovascular procedures. Techniques for managing dislodged stents have included surgical, endovascular, and conservative approaches. This case details a patient who had a covered stent placed within the left renal vein which later migrated to the pulmonary artery causing damage to the tricuspid valve. The migrated stent was successfully removed using a percutaneous endovascular approach utilizing fluoroscopy and transesophageal echocardiogram guidance.
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Affiliation(s)
- Ziga Cizman
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - William Zachery Paden
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Tyler Smith
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Samuel Wilhite
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - David Strain
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Wael Saad
- Department of Interventional Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132, USA
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Franchin M, Coppola A, Muscato P, Cervarolo MC, Piffaretti G, Venturini M, Tozzi M. Stent migration as complication of endovascular treatment of vascular access stenosis: A systemic review. J Vasc Access 2024; 25:407-414. [PMID: 35945812 DOI: 10.1177/11297298221117948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Outflow vein stenosis is one of the commonest complications of both native and prosthetic vascular access. Together with angioplasty, first-line treatment is stenting. Although it has been described as a uncommon complication, the risk of stent migration should be always considered. We aimed to conduct a systematic review of literature concerning stents migration in vascular access, the possible outcomes and treatments. This study was performed applying Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in PubMed/Medline, Scopus, and Google scholar databases. Studies selection, data abstraction was done by two different reviewers. We identified 17 studies, comprising 18 cases (M:F 1:1, mean age 56 ± 18 (range 33-88)). All the patients underwent stenting for vascular access outflow stenosis. The commonest type of device reported was self expandible bare-metal stent. Intraoperative evidence of stent migration occurred in six cases at the final quality control, or for intraprocedure dyspnea onset. In two patients it was a incidental diagnosis. In the remaining cases, chest pain or dyspnea were the common delayed presentation symptoms. Even if stent migration is an uncommon event, it is burdened with low mortality and morbidity. Literature provide only few and frequently inadequate data. Stent removal is the treatment of choice when severe symptoms or cardiopulmonary complication are present. Endovascular procedures demonstrated to be an effective and safe alternative, while open surgical treatment is preferred whenever endovascular therapy failed or in selected cases.
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Affiliation(s)
- Marco Franchin
- Vascular Surgery Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Paola Muscato
- Vascular Surgery Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Maria Cristina Cervarolo
- Vascular Surgery Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Gabriele Piffaretti
- Vascular Surgery Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
| | - Matteo Tozzi
- Vascular Surgery Unit, University of Insubria School of Medicine, Circolo University Teaching Hospital, Varese, Italy
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Liu Z, Zhang J, Huang J, Yao Z, Shen L, Zhou D. Small Oversized Stent Graft Is Associated With Increased Patency for the Treatment of Central Venous Disease in Hemodialysis Patients. J Endovasc Ther 2024:15266028241232921. [PMID: 38361403 DOI: 10.1177/15266028241232921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE The purpose of this study was to identify the independent predictors of higher patency rates and investigate the selection of specifications of stent graft in the treatment of central venous disease. MATERIALS AND METHODS This retrospective study included 54 patients who underwent stent-grafts' placement for the treatment of central venous disease between March 2017 and September 2022 at a tertiary hospital. The demographic data for the patients and the clinical data of the treated lesions were collected and analyzed. The patency rates of the treated lesions with different oversizing range were calculated via the Kaplan-Meier and log-rank analyses. The multivariate Cox proportional hazard models were constructed to identify the independent predictor of the target site primary patency. RESULTS The median follow-up period was 21.5 months. The primary patency rates of the target sites were 90.7%, 72.2%, and 55.1% at 6, 12, and 24 months, respectively. The assisted primary patency rates of the lesions were 96.3%, 92.5%, and 80.3% at 6, 12, and 24 months, respectively. The log-rank analysis showed that the stent-grafts' placement with small oversizing had significantly higher primary patency rates than those with large oversizing (p=0.022). The multivariate analysis revealed that concomitant stenosis and large oversizing stent graft were the independent predictors of target site primary patency. CONCLUSIONS Stent grafts showed reasonable primary patency for the treatment of central venous disease in hemodialysis patients. A stent graft with small oversizing is associated with better target site primary patency rates than those with large oversizing. CLINICAL IMPACT Stent grafts showed reasonable primary patency for the treatment of central venous disease in hemodialysis patients. Few studies, however, have explored the efficiency of stent grafts to treat CVD by considering different factors such as sizing considerations, the rate of oversizing percentage, etc. A stent graft with small oversizing is associated with better target site primary patency rates than those with large oversizing. Excessive oversizing should be avoided to prevent infolding or stent collapse.
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Affiliation(s)
- Zhanao Liu
- Department of Vascular surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Jinru Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jian Huang
- Department of Vascular surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Zhichao Yao
- Department of Vascular surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Liming Shen
- Department of Vascular surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Dayong Zhou
- Department of Vascular surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
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Wei W, Zhao Q, Liu C, Yang L, Li J, Fu P, Zhao Y, Cui T. Stents migration into right atrium from severely calcified superior vena cava in a hemodialysis patient. Heliyon 2024; 10:e23621. [PMID: 38173496 PMCID: PMC10761771 DOI: 10.1016/j.heliyon.2023.e23621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
Vascular calcification is common among hemodialysis patients. In this report, we presented a case of superior vena cava (SVC) stent migration during endovascular angioplasty in a 50-year-old female hemodialysis patient with severe SVC calcification. The stent migration was refractory to the deployment of a second anchor stent, which shortly resulted in pericardium tamponade and was successfully rescued by emergent thoracotomy. The potential role of vascular calcification as a risk factor to stent migration was discussed. Patients with severe vascular calcification receiving endovascular angioplasty might need a careful risk screening for stent migration.
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Affiliation(s)
- Wei Wei
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuyan Zhao
- Outpatient Department, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Caihong Liu
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Letian Yang
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Li
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Fu
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yuliang Zhao
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Tianlei Cui
- Division of Nephrology and Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Zhou B, Huang J, Chen X, Lin C, Xia Y, Jiang R. Clinical analysis and literature review of a complicated superior mesenteric artery stenosis with intestinal necrosis: A case report. Medicine (Baltimore) 2023; 102:e33586. [PMID: 37115070 PMCID: PMC10145880 DOI: 10.1097/md.0000000000033586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
RATIONALE Superior mesenteric artery (SMA) stenosis, as a common arterial disease, if coexists with other possible causes of abdominal pain, is complicated, which may require not only conservative treatment but also surgical intervention. PATIENT CONCERNS A 64-year-old male patient who was admitted to our hospital with pain located around the umbilicus and right lower quadrant for 12 hours. DIAGNOSIS SMA stenosis was initially diagnosed. After balloon dilatation of SMA and stent implantation, computed tomography angiography reexamination showed that the stent was migrated and the stenosis reoccurred. During the ileocecal resection and enterolysis, the necrotic bowel was found and cut open, and the intestinal fistula was found. Combined with his abdominal surgery history, the patient was diagnosed with complicated SMA stenosis with intestinal necrosis. INTERVENTIONS The balloon dilatation of SMA and stent implantation was performed. Because the stent was migrated and the stenosis reoccurred, so a balloon stent was implanted in the proximal stenosis of SMA again. The patient's symptoms were relieved and reoccurred again. The ileocecal resection and enterolysis were performed. OUTCOMES The computed tomography angiography showed that the stents were well deployed and unobstructed after 9 months follow-up. LESSONS When dealing with undetermined abdominal pain that especially has something to do with mesenteric artery ischemia, if there coexists with other possible causes of abdominal pain, we cannot only focus on vascular diseases. We should be vigilant, integrate multiple factors and their interactions to guarantee the accuracy and timeliness of diagnosis and therapy.
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Affiliation(s)
- Binbin Zhou
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Junjie Huang
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaobin Chen
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, China
- Dongfang Hospital, Xiamen University, Fuzhou, China
| | - Chen Lin
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, China
- Dongfang Hospital, Xiamen University, Fuzhou, China
| | - Yin Xia
- Fujian Provincial People’s Hospital, Fuzhou, China
- Department of Vascular Surgery, the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rong Jiang
- Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China
- Department of General Surgery, 900th Hospital of Joint Logistics Support Force, Fuzhou, China
- Dongfang Hospital, Xiamen University, Fuzhou, China
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Essa A, Voong C, AlJaroudi W. Venous Stent Migration of the Right Ventricle. JACC Case Rep 2022; 4:1429-1431. [PMID: 36388719 PMCID: PMC9664006 DOI: 10.1016/j.jaccas.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Peripheral migration of a venous stent to the heart is a rare but known complication, with the heart being the most common site of landing. Echocardiographic modalities are essential in clinical diagnosis and management, particularly with limited data and consensus regarding the best management approach. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Amr Essa
- Medical College of Georgia, Augusta University, Department of Internal Medicine, Division of Cardiology, Augusta, Georgia, USA
| | - Cassandra Voong
- Medical College of Georgia, Augusta University, Department of Internal Medicine, Augusta, Georgia, USA
| | - Wael AlJaroudi
- Medical College of Georgia, Augusta University, Department of Internal Medicine, Division of Cardiology, Augusta, Georgia, USA
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8
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Hosny Sayed DM, Salem DM, Desai KR, O'Sullivan GJ, Black SA. A review of the incidence, outcome and management of venous stent migration. J Vasc Surg Venous Lymphat Disord 2022; 10:482-490. [PMID: 35026448 DOI: 10.1016/j.jvsv.2021.07.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/22/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Percutaneous endovenous stenting has emerged during the last decade as the primary method of treating symptomatic venous outflow obstruction. A recognised complication of venous stenting is stent migration. The aim of this systematic review was to identify the number of cases reported in the published literature describing stent migration, to recognise risk factors that may be associated with this complication, and outcomes following migration. METHODS A review was conducted following MOOSE and PRIMSA guidelines and registered on PROSPERO. MEDLINE, EMBASE, and PubMed databases and key references were searched using specified keywords. All relevant data for primary procedure and subsequent presentation with stent migration was retrieved. Data was assessed as too low quality to allow for statistical analysis. RESULTS Between 1994 and 2020, 31 articles were identified comprised of 29 case reports and 2 case series providing data for 54 events of venous stent migration with 47/54 providing some data for stent used. Mean age of patients in who migration occurred was 50 years (range 19-88) and 57.6% (n=30) were male. Most reported cases were 60mm or less in length (38/46, 82.6%) and only 3 of the reports were stents greater than 14mm in diameter (3/47, 3.6%). None of the papers reported migration of stents of more than 100mm in length. In 85% of the migrated stent events, retrieval was attempted with 56% via an endovascular approach. The immediate outcome was satisfactory in 100% of the reported attempts whether by endovascular or open surgical approaches. CONCLUSIONS This literature review would suggest that the risk of migration is rare but may be underreported. The majority of reported cases are shorter and smaller diameter stents. The paucity of published data and the short term follow up provided suggest more formal data collection would provide a truer reflection of incidence however clear strategies to avoid migration need to be followed to prevent this complication from occurring.
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Affiliation(s)
- Dr Mohamed Hosny Sayed
- Department of Vascular Surgery, Level 1 North Wing Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH
| | - Dr Murtaza Salem
- Department of Vascular Surgery, Level 1 North Wing Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH
| | - Kush R Desai
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA
| | | | - Stephen A Black
- Department of Vascular Surgery, Level 1 North Wing Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH.
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Chen B, Lai Q, Fedally S, Wan Z. Migration of covered stents in thoracic central vein obstruction procedures in patients with hemodialysis: Case report and literature review. Front Cardiovasc Med 2022; 9:954443. [PMID: 35966538 PMCID: PMC9363624 DOI: 10.3389/fcvm.2022.954443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of the study is to present a case of hemodialysis in which the covered stent that had migrated into the right ventricle was retrieved by exploratory thoracotomy, and to review the literature on the diagnosis and treatment of stent migration in thoracic central vein obstruction (TCVO) procedures for hemodialysis patients. METHOD A systematic search of the PubMed database was performed to identify clinical presentations, imaging strategies, stent types, and treatment modalities for stent migration in hemodialysis patients. RESULTS A total of 14 case reports on stent migration in TCVO procedures for hemodialysis patients were included and analyzed. Ten cases included migration to the cardiac chambers and the remainder migration to the pulmonary artery. The common symptoms of stent migration in TCVO procedures are reported to be chest pain and dyspnea, while three of the cases studied involved no symptoms. Echocardiography, chest X-ray, and computed tomography are the commonly used methods for the diagnosis of stent migration and identification of the precise positioning of the stent. Stent migration to the right subclavian or innominate veins was the most prevalent case (seven cases). All were bare stents. Seven cases involved retrieval by interventional surgery, while four cases involved retrieval by open heart surgery. However, there were three cases in which the "wait-and-see" approach was adopted since the patients were asymptomatic. CONCLUSIONS Stent migration in TCVO procedures is a rare but extremely serious complication. The causes are not fully understood. The current treatment strategies include interventional surgery, open heart surgery, and the "wait-and-see" approach.
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Affiliation(s)
- Bo Chen
- Department of Ultrasonography, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiquan Lai
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Swalay Fedally
- Department of Nephrology, SSRN Hospital, Mauritius, Mauritius
| | - Ziming Wan
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Ziming Wan
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10
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Gill J, Akinfolarin A, Szerlip HM. Unexpected Complication in an ESKD Patient during AVG Thrombectomy. KIDNEY360 2021; 2:400-401. [PMID: 35373016 PMCID: PMC8740980 DOI: 10.34067/kid.0004272020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/04/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Jasmeet Gill
- Department of Nephrology, Baylor University Medical Center at Dallas, Dallas, Texas
| | | | - Harold M. Szerlip
- Department of Nephrology, Baylor University Medical Center at Dallas, Dallas, Texas
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Nishan B, Pavan BK, Mamata SH, Anand V. Subclavian arterial stent migration from technical error and effective strategic bail out. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2021. [DOI: 10.4103/ijves.ijves_62_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Zvavanjanja RC. Percutaneous retrieval of migrated Viabahn stent from a segmental pulmonary artery. CVIR Endovasc 2019; 1:1. [PMID: 30652134 PMCID: PMC6319534 DOI: 10.1186/s42155-018-0007-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/05/2018] [Indexed: 12/25/2022] Open
Abstract
Background With improving and aggressive endovascular venous and dialysis techniques there is increasing use of stent grafts with different platforms available on the market. Inappropriately sized stents may displace and potentially end up in the heart or lungs as potential dangerous foreign bodies. There is single published case of successful viabahn stent graft retrieval from the pulmonary circulation. Case presentation We present a patient who had successful safe percutaneous retrieval of a migrated Viabahn stent from a segmental Pulmonary artery and describe a different novel safe technique of successful stent graft retrieval from the pulmonary artery with very low risk to potential damage to the cardiac valve complex. Conclusion This case report demonstrates that Viabahn stent grafts can be safely retrieved from the pulmonary arterial system using this endovascular technique that will significantly reduce the risk of damage to the cardiac valve complex therefore avoiding potential complex surgery. Electronic supplementary material The online version of this article (10.1186/s42155-018-0007-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R C Zvavanjanja
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St, MSB 2.132, Houston, TX 77030 USA
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Anwar S, Vachharajani TJ. Stent use for hemodialysis access: What a general nephrologist needs to know. Hemodial Int 2017; 22:143-149. [DOI: 10.1111/hdi.12608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Siddiq Anwar
- Nephrology Section; King Faisal Specialist Hospital and Research Center; Riyadh Saudi Arabia
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Abstract
Stent migration is an inherent complication of stent deployment. A number of factors are responsible for this dreaded complication. The stent may eventually migrate to the heart or lungs or in the process of migration damage structures en route to its final destination. A number of techniques are available to bail out interventionalists if such a situation should arise. Occasionally a wait and watch approach may be prudent.
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15
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Stander SG, Arora H, Haithcock B, Kumar PA. Acute-Onset Dyspnea and Superior Vena Cava Syndrome During Dialysis. J Cardiothorac Vasc Anesth 2012; 26:1150-2. [DOI: 10.1053/j.jvca.2011.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Indexed: 11/11/2022]
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Abstract
Covered stents or stent grafts are exciting new products with multiple applications for patients with vascular disease, including hemodialysis access-related complications. Although most of the current uses of stent grafts in these settings are "off-label" (ie, not approved by the US Food and Drug Administration) several studies are currently underway to provide the necessary data to support their application. It is clear that stent grafts provide a rapid, effective means for endovascular repair of ruptured access vessels. The commercially available devices and their current applications for treating access-related complications, including aneurysms/pseudoaneurysms, venous outflow stenoses, cephalic arch lesions, ruptures, and diffuse access stenoses, will be reviewed in this article. Available data are reported along with our current clinical practice and algorithms.
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Affiliation(s)
- Eric K Peden
- Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA.
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