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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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Angirekula A, Patel N, Patel K. Successful Surgical Extraction of an Embolized Iliac Vein Stent from the Right Heart: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e943620. [PMID: 38812254 PMCID: PMC11145934 DOI: 10.12659/ajcr.943620] [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: 12/27/2023] [Revised: 04/08/2024] [Accepted: 04/02/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Stenting of the iliac vein remains one of the therapeutic options for the treatment of May-Thurner syndrome. Embolization of peripheral venous stents due to improper technique is a feared complication with an estimated incidence of 1% to 3%. Here we describe an interesting case of an embolized iliac vein stent in the right heart that was successfully extracted via a surgical approach. CASE REPORT A 52-year-old woman with a past medical history of hypertension, diabetes mellitus, and iliac vein stent (16×60 mm Zilver Vena) placement for May-Thurner syndrome presented for evaluation of shortness of breath, chest pain, and dizziness. A chest X-ray was performed, revealing a large stent in the cardiac silhouette. An echocardiogram showed a dense material across the tricuspid valve extending from the right atrium into the right ventricle. A percutaneous endovascular attempt to retrieve the stent was unsuccessful and led only to partial stent retrieval. An open sternotomy approach by a cardiac surgeon revealed the embolized stent across the tricuspid valve covered by endothelial tissue. The stent was successfully extracted without any need for tricuspid valve repair or replacement, followed by an uneventful postoperative recovery. CONCLUSIONS The percutaneous approach is the preferred initial option for the extraction of embolized iliac vein stents into the heart. However, when such an approach fails, the surgical approach remains a feasible option. As reported in this case, the surgical retrieval of a stent can be done without any need for either tricuspid valve repair or replacement.
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Affiliation(s)
- Aakash Angirekula
- College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | - Neil Patel
- College of Natural Sciences, University of Texas at Austin, Austin, TX, USA
| | - Kirit Patel
- Department of Cardiothoracic Surgery, Medical Center Hospital, Odessa, TX, 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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Olsen E, Wilson KA, Ellis J, Kirkpatrick DL, Sherk WM. Management of hepatic caval stenosis and obstruction with modified Gianturco Z-stents. J Vasc Surg Cases Innov Tech 2023; 9:101287. [PMID: 37799840 PMCID: PMC10547823 DOI: 10.1016/j.jvscit.2023.101287] [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: 03/10/2023] [Accepted: 07/18/2023] [Indexed: 10/07/2023] Open
Abstract
Hepatic caval stenosis is managed with stenting; however, stent placement can be complicated by migration, which can be life-threatening. The risk of migration can be mitigated by increasing the length of the stent, which increases contact with the vessel wall. We describe the cases of three patients with hepatic caval stenosis treated with two Z-stents sutured together. Each had an uncomplicated postoperative course and demonstrated clinical improvement. The use of sutured Z-stents can increase the stability of the stent and, therefore, decrease the morbidity associated with stent placement for hepatic caval stenosis.
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Affiliation(s)
- Eric Olsen
- University of Michigan Medical School, Ann Arbor, MI
| | - Kyle A. Wilson
- Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Jordan Ellis
- Department of Radiology, University of Michigan, Ann Arbor, MI
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Pokhriyal SC, Tun MM, Kaphle Bastola AD, Htet SY, Nagpal S. Silent Migration of a Left Common Iliac Venous Stent to the Right Atrium: A Case Report and Review of Literature. Cureus 2023; 15:e40310. [PMID: 37448429 PMCID: PMC10337804 DOI: 10.7759/cureus.40310] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
In the past decade, percutaneous endovenous stenting has emerged as the primary procedure for treating symptomatic venous outflow obstruction. Stent migration is a rare but serious and well-recognized complication of venous stenting. Cardiopulmonary complications following stent migration can manifest in a number of ways, including damage to the valves, arrhythmias, endocarditis, tamponade, and acute heart failure. Both extracardiac and intracardiac dislodgement of stents may be treated with catheter-directed extraction, stent redeployment, or surgical extraction. The decision on the type of procedure depends on multiple factors including the location of the stent, the size and accessibility of the stent, the symptoms, the extent of damage to the vital structures, and the overall health of the patient. We present the case of a 68-year-old male who presented with tachycardia. On further evaluation and workup, he was found to have an iliac venous stent that had migrated to the right atrium.
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Affiliation(s)
| | - Myo Myint Tun
- Internal Medicine, One Brooklyn Health, New York, USA
| | | | - Shwe Yee Htet
- Internal Medicine, Interfaith Medical Center, New York, USA
| | - Sagar Nagpal
- Internal Medicine, University at Buffalo, Buffalo, USA
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6
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Waack A, Jaggernauth S, Sharma S. Bilateral common iliac vein stent migration. Radiol Case Rep 2022; 17:4332-4336. [PMID: 36132062 PMCID: PMC9483646 DOI: 10.1016/j.radcr.2022.08.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022] Open
Abstract
Venous stent migration to the heart is considered to be a rare complication of a common procedure. Therefore, many physicians do not include this complication in their differential diagnosis. We explain why this complication is likely more common than currently thought and why it should be considered as a potential diagnosis. This case describes migration of bilateral iliac vein stents into the right ventricular outflow tract and right interlobar pulmonary artery. We provide multiple imaging modalities demonstrating the migrated stents. We believe radiologists should be cognizant of this complication and consider it as a potential diagnosis. Hopefully, this will create a greater awareness of this life-threatening complication of venous stent placement.
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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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Miller JS, Ramaprabhu K, Mohamed Ahmed E, Halkos ME, Murphy DA. Endoscopic Robotic Retrieval of a Migrated Subclavian Vein Stent from the Right Ventricle. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2021; 16:201-203. [PMID: 33754844 DOI: 10.1177/1556984520986656] [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: 11/16/2022]
Abstract
A 54-year-old woman with end-stage renal disease on hemodialysis with access through a right arm arteriovenous fistula presented with right arm swelling. Venography demonstrated right subclavian vein stenosis. A balloon angioplasty of the stenotic vein was unsuccessful, and she subsequently underwent stent placement with balloon angioplasty. Ten days following the procedure, she developed acute shortness of breath. Transthoracic echocardiogram demonstrated the migration of the venous stent into the right ventricle. Using an endoscopic robotic approach, the stent was successfully extracted from the beating heart.
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Affiliation(s)
- Jeffrey S Miller
- 13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Krithika Ramaprabhu
- 13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Eltayeb Mohamed Ahmed
- 13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael E Halkos
- 13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Douglas A Murphy
- 13713773422646 Department of Surgery, Division of Cardiothoracic Surgery, Emory Saint Joseph's Hospital, Emory University School of Medicine, Atlanta, GA, USA
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10
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Eguchi D, Honma K. Results of Stenting for Central Venous Occlusions and Stenoses in the Hemodialysis Patients. Ann Vasc Dis 2020; 13:235-239. [PMID: 33384724 PMCID: PMC7751087 DOI: 10.3400/avd.oa.20-00114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: We aim to investigate the results of stenting for central venous occlusions and stenoses in the hemodialysis patients. Methods: Twenty-nine cases treated with endovascular recanalization with deployment of bare metal stent (BMS) for central venous occlusions (24 cases) and recurrent stenoses (5 cases) between 2014 and 2018 were retrospectively analyzed. Results of these procedures including success rate, operative time, estimated blood loss, morbidity, primary patency, assisted primary patency and freedom from target-lesion revascularization (TLR) were evaluated. Results: Nine lesions were in brachiocephalic vein (Occlusion/Stenosis: 8/1) and 20 lesions were in subclavian vein (Occlusion/Stenosis: 16/4). Procedural success was 94% (29/31 cases) and operation time/estimated blood loss was 68±39 min/28±54 g. Symptom were relieved or disappeared in all successful cases. Morbidity (extravasation of contrast medium) was 3% (1/29). During the period of observation, 1 stent fracture with occlusion and 1 stent migration to periphery were recognized. 1-year primary patency, freedom from TLR, and assisted primary patency were 40% (median patent time: 256 days), 67% (median patent time: 524 days), and 77%, respectively. Conclusion: Stenting for central venous occlusions and stenoses in the hemodialysis patients is safe and durable treatment option. However, considering its off-label use and potential hazard including vessel rupture, stent migration, and stent fracture, the indication for BMS deployment should be conservative, and interventionist should be well acquainted with prevention and measures to these complications. (This is a translation of Jpn J Vasc Surg 2019; 28: 193–198.)
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Affiliation(s)
| | - Kenichi Honma
- Department of Vascular Surgery, Fukuoka City Hospital
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11
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Ghannam JS, Cooper KJ, Bundy JJ, Srinivasa RN, Patel N, Cline MR, Chick JFB. Endobronchial Forceps-Assisted Removal of Gianturco Z-Stents from the Right Atrium. Ann Vasc Surg 2018; 56:350.e1-350.e4. [PMID: 30218832 DOI: 10.1016/j.avsg.2018.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/06/2018] [Indexed: 11/19/2022]
Abstract
Endovascular treatment of malignant intrahepatic inferior vena cava stenosis involves venoplasty and stenting. Intravascular migration is a complication associated with stents. This technical report describes the retrieval of migrated intracardiac Gianturco Z-stents using rigid endobronchial forceps.
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Affiliation(s)
- Jacob S Ghannam
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI
| | - Kyle J Cooper
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI
| | - Jacob J Bundy
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI
| | - Ravi N Srinivasa
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI; Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, Ronald Reagan Medical Center at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Nishant Patel
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI
| | - Michael R Cline
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI
| | - Jeffrey Forris Beecham Chick
- Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI; Inova Alexandria Hospital, Cardiovascular and Interventional Radiology, Alexandria, VA.
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12
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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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Chen Y, Mou Y, Cheng Y, Wang H, Zheng Z. Late Stent Migration into the Right Ventricle in a Patient with Nutcracker Syndrome. Ann Vasc Surg 2015; 29:839.e1-4. [DOI: 10.1016/j.avsg.2014.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/02/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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14
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Kallstrom E, Rivera J, Hukill A. Incidental Findings in Stress Echocardiography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2014. [DOI: 10.1177/8756479313518110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sonographic follow-up of surgical or other invasive procedures may lead to incidental findings, and knowledge of a patient’s treatment history is an important factor in properly interpreting these results. The treatment regimen for a patient with deep vein thrombosis and its sequelae can include a combination of anticoagulation, thrombolytic therapy, compression stocking, venous bypass, and stenting of the veins. This case presents an incidental finding during a stress echo examination of embolization into the right ventricle of a previously placed iliofemoral venous stent that required surgical removal. It provides an example of the reasons that sonographers need to understand patient history as well as examination protocols to properly evaluate the sonographic images and to anticipate that there may be unexpected findings with every case.
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