Endoscopic Robotic Retrieval of a Migrated Subclavian Vein Stent from the Right Ventricle

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.

Endovascular Retrieval of a Dislocated Stent in the Right Ventricle of a Patient with Nutcracker Syndrome

“…There are many retrieval strategies for migrated stents, including observation, endovascular retrieval, surgical removal, and endoscopic robotic removal. 3,8,9) However, given the high risk of morbidity associated with both surgical and endoscopic robotic removal, endovascular percutaneous removal is an obvious first choice if it can be safely performed. There are many previously reported cases of successful endovascular stent retrieval from the right ventricle, [10][11][12][13][14] and the details of these cases are summarized in the Table . Compared with the techniques used in these previously reported cases, we used a variety of endovascular techniques to retrieve the stent in our case.…”

Multiple migrated superior vena cava stents with cardiac injury - A stepwise open cardiotomy strategy to mitigate potential fatality

“…Several case reports have exhibited that minimally invasive techniques are relatively safe in these patients [ 8 ]. However, there is a lack of a large multi-centre data to support one surgical technique over another.…”