title: Complete atrioventricular block due to venous stent migration from innominate vein to right ventricle: a case report.
abstract: A 78-year-old man who had been treated with maintenance hemodialysis for chronic renal failure was admitted with severe edema in left arm for 1 month. Venous angiography showed a severe stenosis in left innominate vein, then, he underwent percutaneous balloon angioplasty and venous stenting (Wall Stent RP). His arm edema soon improved after angioplasty, however, he complained of general fatigue and bradycardia 2 days after the venous angioplasty. Electrocardiogram showed complete atrioventricular block with 35 wide QRS complexes per minute. His echocardiogram showed a pipe-shaped structure with multiple slit and acoustic shadow in right ventricle. His radiographical right ventriculogram revealed the migrated venous stent from innominate vein to right ventricle. We tried to perform percutaneous transvenous stent extraction using Goose-Neck snare catheter, however, the wall stent stuck in the right external iliac vein, and contrast media leaked to the outside of the vascular wall. Therefore, we implanted this stent in the iliac vein with optimal-sized balloon inflation, and succeeded in stopping bleeding. Complete atrioventricular block was recovered to sinus rhythm with left bundle branch block just after the removal of the venous stent from right ventricle, and no cardiovascular events occurred after the treatment.
authors.affiliation: Department of Cardiology, Okitama Public General Hospital, Higashi-okitama-gun, Yamagata, Japan. kzkaneko@nihonkai.gr.jp
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kaneko
authors.forename: Osamu
authors.initials: O
authors.lastname: Hirono
authors.forename: Kouichi
authors.initials: K
authors.lastname: Yuuki
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ishino
authors.forename: Hyuuma
authors.initials: H
authors.lastname: Daidouji
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ito
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D054537:Atrioventricular Block / Q000209:etiology* / Q000628:therapy*; D016121:Brachiocephalic Veins; D003251:Constriction, Pathologic; D005548:Foreign-Body Migration / Q000209:etiology* / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D007084:Iliac Vein; D008297:Male; D011475:Prosthesis Failure; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome