Burbank Emily, Tice Kevin
Cardiovascular Medicine, Edward Via College of Osteopathic Medicine, Auburn, USA.
Internal Medicine, Grandview Medical Center, Birmingham, USA.
Cureus. 2024 Jun 3;16(6):e61575. doi: 10.7759/cureus.61575. eCollection 2024 Jun.
Over the past several decades, percutaneous venous stenting has surfaced as the forefront for addressing symptomatic venous outflow obstruction. Stent migration is a very rare, but serious life-threatening complication that can occur with the placement of iliofemoral stents. Life-threatening complications following stent migration include but are not limited to damaged valves, arrhythmias, endocarditis, tamponade, and acute heart failure. Stent failure is seldom understood, but one can attribute it to the incorrect stent and or vein sizing and or the inherent natural forces of the body during respiration. Intravascular ultrasound (IVUS) should be utilized for proper vein and stent sizing prior to placement and patients should be monitored more closely after the procedure. Stent retrieval can be very difficult, as the procedure must consider the location of the migrated stent and the comorbidities associated with the patient. This case report explains an 81-year-old Caucasian male who presented to the Emergency Department with dizziness and dyspnea on exertion. Upon further evaluation via transesophageal echocardiogram, he was found to have severe tricuspid regurgitation and an iliofemoral venous stent located in the right ventricle of the heart.
在过去几十年中,经皮静脉支架置入术已成为治疗有症状的静脉流出道梗阻的前沿方法。支架移位是一种非常罕见但严重危及生命的并发症,可发生在髂股静脉支架置入过程中。支架移位后的危及生命的并发症包括但不限于瓣膜损伤、心律失常、心内膜炎、心包填塞和急性心力衰竭。支架失败很少被理解,但可以归因于支架和/或静脉尺寸选择不当,以及呼吸过程中身体的固有自然力。在放置支架之前,应使用血管内超声(IVUS)来正确测量静脉和支架的尺寸,术后应对患者进行更密切的监测。取出支架可能非常困难,因为该操作必须考虑移位支架的位置以及患者的合并症。本病例报告介绍了一名81岁的白种男性,他因头晕和劳力性呼吸困难就诊于急诊科。经食管超声心动图进一步评估后,发现他患有严重的三尖瓣反流,且一枚髂股静脉支架位于心脏右心室。