1
|
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] [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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Duque JC, Tabbara M, Martinez L, Manzur-Pineda K, Vazquez-Padron RI, Dejman A. An atypical case of hemodialysis access stent migration. Clin Nephrol Case Stud 2022; 10:28-31. [PMID: 35096511 PMCID: PMC8795986 DOI: 10.5414/cncs110737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/02/2021] [Indexed: 01/14/2023] Open
Abstract
Endovascular stent fractures are commonly seen in arteries but are rare events in the venous system. Stents deployed in hemodialysis vascular accesses can fracture and migrate to proximal locations. Complications associated with stent fracture include in-stent stenosis and central vein stenosis. In this report, we present a unique case of a hemodialysis access stent fracture that migrated to the left ventricle and manifested with chest pain.
Collapse
Affiliation(s)
- Juan C. Duque
- Katz Family Division of Nephrology and Hypertension, and
| | - Marwan Tabbara
- DeWitt Daughtry Family Department of Surgery, Division of Vascular and Endovascular Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laisel Martinez
- DeWitt Daughtry Family Department of Surgery, Division of Vascular and Endovascular Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karen Manzur-Pineda
- DeWitt Daughtry Family Department of Surgery, Division of Vascular and Endovascular Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Roberto I. Vazquez-Padron
- DeWitt Daughtry Family Department of Surgery, Division of Vascular and Endovascular Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adriana Dejman
- Katz Family Division of Nephrology and Hypertension, and
| |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
7
|
Park YC, Kim HO, Yim NY, Lee BC, Park C, Jo YG, Kim JC, Jeong WG. Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report. J Endovasc Ther 2021; 28:950-954. [PMID: 34152228 DOI: 10.1177/15266028211025024] [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
PURPOSE The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. CASE REPORT A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient's hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. CONCLUSION Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.
Collapse
Affiliation(s)
- Yun Chul Park
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Hyoung Ook Kim
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Nam Yeol Yim
- Department of Radiology, Mirae Clinic, Gwangju, South Korea
| | - Byung Chan Lee
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Chan Park
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
| | - Young Goun Jo
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Jung Chul Kim
- Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Hospital, Gwangju, South Korea
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Patel A, Chan SXJM, Zhuang KD. Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device. CVIR Endovasc 2020; 3:7. [PMID: 32026190 PMCID: PMC6966347 DOI: 10.1186/s42155-020-0098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/08/2020] [Indexed: 11/25/2022] Open
Abstract
Background Stent placement in the cephalic arch is being used with increasing frequency. Late complications of bare metal and stent grafts in dialysis access, in particular stent migration, are often under-reported and can lead to compromise of future dialysis circuits. Case presentation A 52-year-old man developed acute arm swelling 2 days after creation of a left arm brachio-basilic arteriovenous graft. The axillary vein was found to be jailed by a previously deployed cephalic arch stent graft which had migrated into the subclavian vein. There was failure to cross through the fabric of the stent graft using conventional chronic total occlusion wires and techniques. A TruePath device was used successfully to cross through the fabric of migrated cephalic arch stent graft and recanalise the short subclavian-axillary vein occlusion. Conclusion The adapted use of a drilling chronic total occlusion device to drill through the fabric of migrated stent graft was performed successfully to allow complete recanalisation of the occluded axillary vein.
Collapse
|
10
|
Kim CS, Kim HY, Lee KS, Bae EH, Ma SK, Kim SW. Vascular Stent Migration to Right Ventricle. Korean Circ J 2019; 49:769-770. [PMID: 31347323 PMCID: PMC6675690 DOI: 10.4070/kcj.2019.0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/07/2019] [Accepted: 07/04/2019] [Indexed: 12/01/2022] Open
Affiliation(s)
- Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hyung Yoon Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Kyo Seon Lee
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|
11
|
Rossi UG, Rollandi GA, Ierardi AM, Valdata A, Pinna F, Pescatori LC, Gallieni M, Carrafiello G, Cariati M. Materials and techniques for percutaneous retrieval of intravascular foreign bodies. J Vasc Access 2018; 20:87-94. [PMID: 29976095 DOI: 10.1177/1129729818785051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The presence of an intravascular foreign body represents a well-known risk of serious complications. While in the past surgical removal of intravascular foreign body was the most common intervention, nowadays a percutaneous approach in the retrieval of an intravascular foreign body is widely accepted as the first-line technique. In the literature, many case reports describe different techniques and materials. This article summarizes and illustrates the main materials and techniques currently applied for percutaneous retrieval of intravascular foreign body, providing a simplified tool with different interventional possibilities, adaptable to different clinical situations.
Collapse
Affiliation(s)
- Umberto G Rossi
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | - Gian Andrea Rollandi
- 2 Department of Diagnostic Imaging, Radiology Unit, Galliera Hospital, Genova, Italy
| | - Anna Maria Ierardi
- 3 Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Paolo Hospital, Milan, Italy
| | - Alessandro Valdata
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | - Francesco Pinna
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | | | - Maurizio Gallieni
- 5 Nephrology and Dialysis Unit, ASST Santi Paolo and Carlo Hospital, Milan, Italy
| | - Gianpaolo Carrafiello
- 3 Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Paolo Hospital, Milan, Italy
| | - Maurizio Cariati
- 6 Department of Diagnostic Science, Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Carlo Borromeo Hospital, Milan, Italy
| |
Collapse
|
12
|
Abstract
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents. The latest randomized control trials reveal that stents decrease the number of interventions required to maintain patency but do not improve the overall access survival. Furthermore, bare metal stents have been shown to be inferior to stent grafts. This review discusses indications for stent deployment in the hemodialysis access, the current evidence for their use, and briefly touches on their complications.
Collapse
Affiliation(s)
- Kenneth Abreo
- School of Medicine, LSU Health Shreveport, Shreveport, LA, USA
| | - Adrian Sequeira
- School of Medicine, LSU Health Shreveport, Shreveport, LA, USA
| |
Collapse
|
13
|
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
| | | |
Collapse
|
14
|
A simple indispensable maneuver to prevent stent migration during deployment. J Vasc Access 2017; 18:e52. [DOI: 10.5301/jva.5000714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2017] [Indexed: 11/20/2022] Open
|