AUTHOR=Chen Bo , Lai Qiquan , Fedally Swalay , Wan Ziming 

TITLE=Migration of covered stents in thoracic central vein obstruction procedures in patients with hemodialysis: Case report and literature review

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.954443

DOI=10.3389/fcvm.2022.954443

ISSN=2297-055X

ABSTRACT=Objective: To present a case of hemodialysis in which the covered stent that had migrated into the right ventricle was retrieved using 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 type, and the 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 the 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-rays, and computed tomography are the commonly used methods for the diagnosis of stent migration and the precise positioning of the stent. Migration stents located in the right subclavian or innominate veins were the most prevalent cases (seven cases). All the stents were bare stents. Seven cases involved retrieval via interventional surgery, while four cases involved retrieval through 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.