Stent Migration Following Endovascular Intervention in May-Thurner Syndrome

TL;DR

A stent used to treat May-Thurner syndrome migrated to the heart, causing complications that required surgical removal.

Contribution

This case highlights a rare but serious complication of venous stenting and presents a successful minimally invasive treatment approach.

Findings

Stent migration occurred in a patient with May-Thurner syndrome, reaching the right side of the heart.

A minimally invasive thoracotomy successfully removed the stent and repaired tricuspid valve damage.

Percutaneous retrieval methods failed, emphasizing the need for alternative surgical approaches in such cases.

Abstract

Developments in endovascular therapies have made stenting a common practice in the treatment of peripheral vascular diseases, including venous disorders such as May-Thurner syndrome. The placement of a stent in the venous system carries the risk of stent migration which although small occurs with a 3% incidence rate and can be life-threatening given the risk of pulmonary infarction, tricuspid regurgitation, and right-sided heart failure. Herein we report a case of stent embolization from the common iliac vein into the right side of the heart causing tricuspid regurgitation. After the failure of percutaneous approach to retrieve the stent, it was successfully removed using a minimally invasive right thoracotomy approach along with repair of the tricuspid valve.