Intracardiac Venous Stent Migration: Emergency Department Presentation of a Catastrophic Complication

Publication date: Available online 21 March 2017
Source:The Journal of Emergency Medicine
Author(s): Eric Steinberg, Christopher Gentile, Michael Heller, Nicole Kaban, Erica Bang, Terry Li
BackgroundVenous stents are commonly placed to ensure patency in patients with chronic peripheral venous insufficiency. Although serious complications are uncommon, peripheral venous stent placement can have some potentially life-threatening complications. One of the most feared, and certainly the most dramatic, complication is stent migration.Case ReportWe report on a 55-year-old woman with transvenous migration of an infrarenal inferior vena cava stent into the right atrium and through the intra-atrial septum. The patient expired in the emergency department (ED).Why Should an Emergency Physician Be Aware of This?There are several potentially life-threatening post-surgical complications after an endovascular procedure, some of which occur shortly after the patient is discharged from the recovery unit. Frequently, these patients present to the ED for initial evaluation. Although details of the procedure performed and the surgical intervention might not be available immediately, emergency physicians should consider stent migration when a patient presents in extremis shortly after an endovascular procedure.



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