Management of misplaced or migrated endovascular stents

PURPOSE: To report experience with techniques for management of misplaced o r migrated endovascular stents. MATERIALS AND METHODS: During a B-year period, percutaneous management of 2 7 misplaced or migrated endovascular stents (16 Palmaz, 11 Wallstents) in 2 5 patients was attempted, The 17 venous and 10 arterial stents were rescued from the aorta (n = 9), inferior vena cava (IVC) (n = 4), transjugular int rahepatic portosystemic shunt/IVC (n = 2), right atrium (n = 3), right vent ricle (rt = 2), pulmonary artery (n = 2), iliac vein (n = 2), iliac artery (n = 1), superior vena cava (n = 1), and superior mesenteric vein (n = 1). RESULTS: Stent management was successful in 26 of 27 cases (96%). Eleven st ents were removed percutaneously, two were repositioned and removed with a minor surgical procedure, and 13 were repositioned and deployed in a stable alternate location, The only complication was the development of tricuspid insufficiency in the single case in which the procedure failed (4% complic ation rate). This patient's stent was eventually surgically removed from th e right ventricle. CONCLUSION: Misplaced or migrated endovascular Palmaz and Wallstents can be effectively managed with few complications by using a variety of percutane ous techniques.