Intracardiac Venous Stent Migration: Emergency Department Presentation of a Catastrophic Complication.
BACKGROUND
Venous stents are commonly placed to ensure patency in patients with chronic peripheral venous insufficiency. Although serious complications are uncommon, peripheral venous stent placement can have some potentially life-threatening complications. One of the most feared, and certainly the most dramatic, complication is stent migration.


METHODS
We report on a 55-year-old woman with transvenous migration of an infrarenal inferior vena cava stent into the right atrium and through the intra-atrial septum. The patient expired in the emergency department (ED). WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: There are several potentially life-threatening post-surgical complications after an endovascular procedure, some of which occur shortly after the patient is discharged from the recovery unit. Frequently, these patients present to the ED for initial evaluation. Although details of the procedure performed and the surgical intervention might not be available immediately, emergency physicians should consider stent migration when a patient presents in extremis shortly after an endovascular procedure.
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Eric
E
Steinberg
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Christopher
C
Gentile
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Michael
M
Heller
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Nicole
N
Kaban
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Erica
E
Bang
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.
Terry
T
Li
D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000494:pharmacology / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D014682:Vena Cava, Inferior / Q000503:physiopathology / Q000601:surgery; D014689:Venous Insufficiency / Q000601:surgery*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
postoperative complication; shock; stent migration; venous stent