Endovascular Stent Migration to the Right Ventricle Causing Myocardial Injury

Abstract

Central stenosis of the subclavian and internal jugular veins is common in end stage renal disease. Treatment of these stenoses is difficult as these veins respond poorly to angioplasty alone and often require metallic stents to ensure patency. These stents are not without complications. Reports of stent fracture, thrombosis and vessel rupture abound in the literature. Stent migration can occur when used in large central veins leading to severe consequences such as pulmonary infarction, tricuspid regurgitation and right sided heart failure. In this report, we report a case of a subclavian vein stent which migrated into the right heart and caused subendocardial injury. As the use of vascular stents is becoming a common treatment option for central venous stenosis, the occurrences of serious complications associated with the stents are likely to rise.

Foreign Bodies in the Heart

“…Larger devices than catheters and migrated stents [31][32][33][34][35][36][37][38][39][40] cause symptoms more often than catheters and are discovered shortly after insertion, between 1 day and 1 year. Cardiac injury is more extensive in the aorto-right atrial fistula with a perforation of the interatrial septum (2 patients) and 35,36 bloody pericardial effusion in 1.…”

CT-assisted transfemoral intrahepatic portosystemic shunt in a long duration follow-up: A case report

“…Stent fracture in the venous circulation occurs even less frequently (reported in single case reports) [9] and there are no reports on Nitinol stent fractures in TIPS patients. Nevertheless, an atypically angulated TIPS tract, continuous strain due to respiratory movements and stent protrusion into the inferior vena cava, all have predisposed the stent to fracture.…”

Right Ventricle Foreign Body: A Case of a Migrating Iliac Stent Entrapped in the Tricuspid Valve

“…The incidence of stent migration as a complication of endovascular stenting is reported to be as low as 3% of all percutaneous stenting procedures [3]. Location of the lesion, deployment technique, appropriate stent size and external trauma are essential contributing factors to stent migration.…”