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Iliac vein stent migration with extensive cardiac damage in a patient with May-Thurner syndrome

Daniel Regan1, Sarah Mistrot, Curtis Anderson

  • 1At UNC Rex Healthcare in Raleigh, N.C., Daniel Regan and Sarah Mistrot practice in cardiac surgery, Curtis Anderson is medical director and an attending cardiac surgeon, and Alan Kypson is an attending cardiac surgeon. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|August 26, 2020
PubMed

Insights

May-Thurner syndrome, a cause of deep vein thrombosis, involves iliac vein compression. A patient experienced a rare complication where an iliac vein stent migrated to the right ventricle, causing significant damage.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • May-Thurner syndrome (MTS), or iliac vein compression syndrome, occurs when the left common iliac vein is compressed.
  • This compression increases the risk of deep vein thrombosis (DVT).
  • Iliac vein stenting is a standard treatment for symptomatic MTS.

Observation:

  • This report details a unique case of stent migration.
  • The iliac vein stent completely embolized to the patient's right ventricle.
  • The migrated stent caused extensive damage to cardiac structures.

Findings:

  • Stent embolization to the right ventricle is a rare but severe complication of iliac vein stenting.
  • The case highlights the potential for catastrophic device failure.
  • Damage to cardiac structures necessitates urgent intervention.

Implications:

  • This case underscores the importance of careful patient selection and monitoring after iliac vein stenting.
  • It suggests a need for improved stent design or deployment techniques to prevent migration.
  • Further research into managing such rare complications is warranted.

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