A review of the incidence, outcome and management of venous stent migration

Abstract Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS). Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success. Results 11 patients (45 % women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91 % (10/11) and 80 % (8/10) of patients, respectively. There was one adverse event (9 %) due to stent migration. Two patients (18 %) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days. Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

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Stent Embolization Mimicking Acute Myocardial Infarction

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211036537 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110365

Author(s):

Syed Arqum Huda ◽

Sara Akram Kahlown ◽

Anojan Pathmanathan ◽

Muhammad Saad Farooqi ◽

Mark Charlamb

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Stent Migration ◽

Safe Procedure ◽

Significant Morbidity ◽

Fatal Complication ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Venous Stents

Venous thromboembolism is associated with significant morbidity and mortality if left untreated. Anticoagulation is the cornerstone of treatment. Venous stents are a relatively newer entity that are increasingly being used to treat venous stenosis/occlusion. It is a safe procedure, but complications include vein rupture, arterial puncture, retroperitoneal bleeding, and in-stent thrombosis. Stent migration is a rare but potentially fatal complication. We present a case of venous stent embolization to the heart that presented as a non-ST segment elevation myocardial infarction.

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Endovascular treatment of aortic coarctation with a novel BeGraft aortic stent in children and young adults: a single-centre experience with short-term follow-up results

Cardiology in the Young ◽

10.1017/s1047951121002389 ◽

2021 ◽

pp. 1-8

Author(s):

Murat Muhtar Yılmazer ◽

Gamze Vuran ◽

Timur Meşe ◽

Barış Güven ◽

Cüneyt Zihni ◽

...

Keyword(s):

Abdominal Aorta ◽

Aortic Coarctation ◽

Paediatric Population ◽

Stent Migration ◽

Long Term Results ◽

Single Centre ◽

Surgical Closure ◽

Stent Restenosis ◽

Stent Diameter

Abstract Objectives: We present our experience and outcomes with the BeGraft in the treatment of aortic coarctation in a predominantly paediatric population. Methods: This study includes a retrospective analysis of patients who had Begraft aortic stent implantation between 2018 and 2020 from a single centre. Results: The BeGraft aortic stent was used in 11 patients (7 males, 4 females) with a median age of 14 (13–21) years and a median weight of 65 (46–103) kg. Coarctation was native in five patients and recurrent in six patients. Median stent diameter and length were 16 mm and 38 mm, respectively. The median peak-to-peak pressure was 30 (12–55) mmHg before the procedure and 5 (0–17) mmHg after the procedure. The stenting procedure was successful in 10 of the 11 patients. Stent migration to the abdominal aorta occurred on post-procedure day 1 in the 21-year-old patient, who had previously undergone surgical closure of the ventricular septal defect and balloon angioplasty for coarctation. After repositioning failed, the stent was safely fixed in the abdominal aorta. Strut distortion also occurred during balloon retrieval in one patient, but no aneurysm or in-stent restenosis was observed at 1-year follow-up. The patients were followed for a median of 14 (4–25) months and none required redilation. Conclusions: Our initial results demonstrated that the BeGraft aortic stent effectively reduced the pressure gradient in selected native and recurrent cases. Despite advantages such as a smaller sheath and low profile, more experience and medium- to long-term results are needed.

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Effectiveness of a Novel Covered Stent without External Thread Fixation for Anastomotic Leakage after Total or Proximal Gastrectomy for Gastric Cancer

Cancers ◽

10.3390/cancers13153720 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3720

Author(s):

Young-Il Kim ◽

Chan Gyoo Kim ◽

Jong Yeul Lee ◽

Il Ju Choi ◽

Bang Wool Eom ◽

...

Keyword(s):

Gastric Cancer ◽

Anastomotic Leakage ◽

Stent Placement ◽

Proximal Gastrectomy ◽

Stent Migration ◽

Covered Stent ◽

Double Layers ◽

Stent Group ◽

Hospitalization Period ◽

Gastric Cancer Patients

A thread-fix stent entails long hospitalization and patient discomfort. We aimed to evaluate the efficacy of a novel stent with silicone-covered outer double layers without external fixation (Beta stent) for anastomotic leakage after total or proximal gastrectomy. The outcomes were compared between gastric cancer patients who underwent stent placement using a thread-fix stent between 2014 and 2015 (Thread-Fix Group) and those who received a Beta stent in the succeeding period until October 2018 (Beta Stent Group). The Beta Stent Group (n = 14) had a significantly higher leakage healing rate by the first stent placement (92.9% vs. 53.8%; p = 0.021) and had a shorter hospitalization period (median: 16 days vs. 28 days; p = 0.037) than the Thread-Fix Group (n = 13). Further, 50% of the Beta stent patients received outpatient management until stent removal. Stent maintenance duration was significantly longer in the Beta Stent Group (median, 28 days vs. 18 days; p = 0.006). There was no significant between-group difference in stent-related complications except for stent migration (7.1% (Beta Stent Group) vs. 0% (Thread-Fix Group), p = 0.326). In conclusion, the Niti-S Beta stent is an effective treatment for anastomotic leakage from total or proximal gastrectomy for gastric cancer. Stent maintenance is possible without hospitalization.

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Biliary stent migration as a cause of cardiac tamponade

Journal of Cardiovascular Medicine ◽

10.2459/jcm.0b013e3283632933 ◽

2013 ◽

Vol 14 (10) ◽

pp. 750-752 ◽

Cited By ~ 3

Author(s):

Victor Lee ◽

Simon Woldman ◽

Pascal Meier

Keyword(s):

Cardiac Tamponade ◽

Stent Migration ◽

Biliary Stent

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Peri-Procedural Morbidity and Mortality Associated with Stent-Assisted Coiling for Intracranial Aneurysms

Interventional Neuroradiology ◽

10.1177/159101991301900106 ◽

2013 ◽

Vol 19 (1) ◽

pp. 43-48 ◽

Cited By ~ 10

Author(s):

K. Wang ◽

Y. Sun ◽

A-M. Li

Keyword(s):

Intracranial Aneurysms ◽

Cerebral Aneurysms ◽

Mortality Rates ◽

Stent Migration ◽

Aneurysm Rupture ◽

Morbidity And Mortality ◽

Unruptured Aneurysms ◽

Ruptured Aneurysms ◽

Attractive Option ◽

Technological Improvements

Despite experience and technological improvements, stent-assisted coiling for intracranial aneurysms still has inherent risks. We evaluated peri-procedural morbidity and mortality associated with stent-assisted coiling for intracranial aneurysms. Patients with cerebral aneurysms that were broad-based (>4 mm) or had unfavorable dome/neck ratios (<1.5) were enrolled in this study between February and November 2011 at our center. Aneurysms were treated with the self-expanding neurovascular stents with adjunctive coil embolization. Seventy-two consecutive patients (27 men and 45 women; 22–78 years of age; mean age, 52.8 years) underwent 13 procedures for 13 ruptured aneurysms and 64 procedures for 73 unruptured aneurysms. Nine [11.7%, 95% CI(4.5%–18.9%)] procedure-related complications occurred: one and eight with initial embolization of ruptured and unruptured aneurysms, respectively. Complications included six acute in-stent thromboses, one spontaneous stent migration, one post-procedural aneurysm rupture, and one perforator occlusion. Three complications had no neurologic consequences. Two caused transient neurologic morbidity, two persistent neurologic morbidity, and two death. Procedure-related neurologic morbidity and mortality rates, respectively, were as follows: overall, 5.2% (95%CI, 0.2%–10.2%) and 2.6% (95%CI, 0%–6.2%); ruptured aneurysms, 7.7% (95%CI, 0%–36%) and 0% (95%CI, 0%–25%); unruptured aneurysms, 4.7% (95%CI, 0%–9.9%) and 3.1% (95%CI, 0%–7.3%). Combined procedure-related morbidity and mortality rates for ruptured and unruptured aneurysms were 7.7% (95%CI, 1.7%–13.7%) and 7.8% (95%CI, 1.8%–13.8%), respectively. Stent-assisted coiling is an attractive option for intracranial aneurysms. However, stent-assisted coiling for unruptured aneurysms is controversial for its comparable risk to natural history.

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