Key result
Open heart surgery successfully retrieves an endovascular stent migrated into the RV and tricuspid valve.
Why the study?
Stent migration into the heart during endovascular treatment of central venous stenosis in chronic renal failure patients on hemodialysis is a rare but serious complication with limited treatment guidance.
Case Report (n=1)
No
Open heart surgery should be considered without hesitation for retrieving stents that migrate to the right ventricle or pulmonary artery during endovascular treatment, due to the high risk of fatal complications and difficulty of percutaneous retrieval.
Cardiac stent migration in dialysis patients may require open retrieval due to endovascular risks; leaves open optimal prevention and management strategies.
現在，慢性腎不全・血液透析患者において中心静脈（鎖骨下静脈・腕頭静脈・上下大静脈）の狭窄はしばしば生じる合併症である．現在，透析患者の長期化・高齢化と血管内治療の導入・進展により治療となる症例は多い．合併症として血管内治療で使用したカテーテル・デバイスが破損・脱落により血管内を遊走（以下，migration）が生じ，問題となることが稀にある．今回，慢性腎不全・血液透析導入患者における鎖骨下静脈狭窄に対し血管内治療を施行した際に，ステントが心臓内にmigrationし，開心術にて摘出した症例を経験した．心臓内の特に右室や肺動脈へのmigrationはステントstrutの影響により血管内治療での回収は困難で，心筋・肺動脈の損傷や三尖弁機能不全のリスクが高く，時に致死的なリスクを招くことがあり，開心術の選択を躊躇すべきではない．
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Masayuki Fujisaki (2024) conducted a case report in Central venous stenosis (n=1). Surgical removal (open heart surgery) was evaluated on Successful removal of the migrated stent. Open heart surgery successfully removed a stent that had migrated to the right ventricle and entangled with the tricuspid valve during endovascular treatment for subclavian vein stenosis.
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