Percutaneous techniques for managing maldeployed or migrated stents.
OBJECTIVE
To report our experience in the percutaneous management of dislocated endovascular stents.


METHODS
During a 6-year period, 28 (2.7%) patients with a maldeployed or migrated endovascular stent (20 Palmaz, 5 Wallstent, 2 Memotherm, and 1 AVE) were recognized among 1021 patients undergoing noncardiac vascular stent procedures. Percutaneous stent management was performed using balloon catheters, gooseneck snares, grasping forceps, or additional stent implantation on the basis of the stent type, degree of expansion, mechanical characteristics, and location of the stent.


RESULTS
Three stents that embolized into the pulmonary artery were left in situ, but percutaneous management was successful in 23 (92%) of the remaining 25 dislocated stents (12 venous and 13 arterial stents). Twelve stents were repositioned in an alternate, stable position or the primarily intended location; 4 stents were anchored by a second stent, and 7 stents were removed percutaneously. In the 2 failed cases, the stents were retrieved using a minor surgical procedure. There were 2 minor groin hematomas but no secondary complications during a median follow-up of 26.2 months (range 1-62).


CONCLUSIONS
Percutaneous management of migrated or maldeployed endovascular stents is highly effective with few complications. On the basis of our findings, these techniques should be considered the therapy of choice.
Gabelmann
A
A
Department of Diagnostic Radiology, University Hospitals of Ulm, Germany. andreas.gabelmann@medizin.uni-ulm.de
Krämer
S C
SC
Tomczak
R
R
Görich
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery; D015607:Stents; D014656:Vascular Surgical Procedures / Q000295:instrumentation; D014682:Vena Cava, Inferior / Q000601:surgery; D014683:Vena Cava, Superior / Q000601:surgery