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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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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: 26] [Impact Index Per Article: 13.0] [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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Khaddash I, Hawatmeh A, Dayrit-Demetillo C, Hamdan A. Migrated Subclavian Venous Stent into the Right Atrium. J Cardiovasc Ultrasound 2016; 24:251-252. [PMID: 27721958 PMCID: PMC5050316 DOI: 10.4250/jcu.2016.24.3.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/29/2016] [Accepted: 07/26/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ibrahim Khaddash
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, Paterson, NJ, USA
| | - Amer Hawatmeh
- Department of Cardiology, Saint Michael's Medical Center, New York Medical College, Newark, NJ, USA
| | - Cynthia Dayrit-Demetillo
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, Paterson, NJ, USA
| | - Aiman Hamdan
- Department of Cardiology, Saint Joseph's Regional Medical Center, New York Medical College, Paterson, NJ, USA
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Cordial R, Moussavian MR, Corvalan J, Görtz H, Teßarek J. Percutaneous endovascular Y-stenting of a malignant superior vena cava and innominate vein obstruction. Vasc Endovascular Surg 2013; 48:77-9. [PMID: 24122722 DOI: 10.1177/1538574413507982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Superior vena cava syndrome (SVCS) is considered one of the telltale signs of a terminal malignant process. We describe a successful endovascular desobliteration of a subtotal occluded SVC and the left innominate vein using a Y-stent technique in a 46-year-old female with a mediastinal nodal metastasis of a relapsing renal cell carcinoma. Complete clinical improvement in the symptoms within the first 24 hours of the procedure and no complication were observed. This report describes endovascular stenting of the SVC as a palliation therapy to overcome the severe clinical symptoms of SVCS besides surgical or chemotherapy in mediastinal malignancy masses.
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Affiliation(s)
- Reginald Cordial
- 1Department of Vascular and Endovascular Surgery, Saint Bonifatius Hospital, 49808 Lingen, Germany
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Abusaid GH, Cheema OM, Xie T, Mercado-Young RA, Ahmad M. Real time three-dimensional echocardiography and endovascular stenting. Echocardiography 2012; 29:E214-5. [PMID: 22639895 DOI: 10.1111/j.1540-8175.2012.01730.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A 52-year-old male with HIV and chronic renal failure presented with 2-day history of fever and chills. He had recent superior vena cava (SVC) stent placement for SVC stenosis following multiple dialysis-catheter insertions. Patient's blood cultures grew methicillin-resistant staphylococcus aureus. Two-dimensional (2D) echocardiography showed no vegetations. With high clinical suspicion, 2D transesophageal echocardiogram (TEE) was obtained and confirmed no endocarditis and patent stent at SVC right atrial junction; however, entire stent was not visualized. Simultaneous three-dimensional TEE provided superior views of SVC stent in cross-sectional and longitudinal planes, clearly demonstrating patent stent without vegetations, stenosis, migration, or thrombosis.
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Affiliation(s)
- Ghassan H Abusaid
- Department of Internal Medicine-Cardiology Division, University of Texas Medical Branch, Galveston, Texas 77555-0553, USA
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Kang W, Kim IS, Kim JU, Cheon JH, Kim SK, Ko SH, Kim SH, Lee SW, Cho SH. Surgical removal of endovascular stent after migration to the right ventricle following right subclavian vein deployment for treatment of central venous stenosis. J Cardiovasc Ultrasound 2011; 19:203-6. [PMID: 22259665 PMCID: PMC3259546 DOI: 10.4250/jcu.2011.19.4.203] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 09/27/2011] [Accepted: 11/30/2011] [Indexed: 11/22/2022] Open
Abstract
Central venous stenosis or occlusion occurs in 11-50% of hemodialysis patients with prior subclavian vein cannulation and ipsilateral fistula or shunt. Most patients are asymptomatic but some require treatment to reduce the risk of thrombosis and improve inadequate hemodialysis pressure. In these cases, endovascular intervention, including ballooning and stenting, is a feasible strategy for selected patents. We report an unusual case of a 40-year-old man on hemodialysis that underwent endovascular stenting to treat right subclavian vein stenosis and experienced stent migration to the right ventricle, requiring surgical removal.
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Affiliation(s)
- Wook Kang
- Department of Internal Medicine, Busan Veterans Hospital, Busan, Korea
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Ahamed SH, Venkatesh SK, Tan LKA. Migrated Brachiocephalic Venous Stent into the Right Atrium – Can it be Left Alone? A Case Report and Review of the Literature. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2011. [DOI: 10.47102/annals-acadmedsg.v40n11p512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Complete atrioventricular block due to venous stent migration from innominated vein to right ventricle: A case report. J Cardiol 2009; 53:453-7. [DOI: 10.1016/j.jjcc.2008.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 08/29/2008] [Accepted: 09/03/2008] [Indexed: 11/22/2022]
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