Percutaneous techniques for managing maldeployed or migrated stents

Purpose: To report our experience in the percutaneous management of disloca ted endovascular stents. Methods: During a 6-year period, 28 (2.7%) patients with a maldeployed or m igrated endovascular stent (20 Palmaz, 5 Wallstent, 2 Memotherm, and 1 AVE) were recognized among 1021 patients undergoing noncardiac vascular stent p rocedures. Percutaneous stent management was performed using balloon cathet ers, gooseneck snares, grasping forceps, or additional stent implantation o n the basis of the stent type, degree of expansion, mechanical characterist ics, 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 remain ing 25 dislocated stents (12 venous and 13 arterial stents). Twelve stents were repositioned in an alternate, stable position or the primarily intende d location; 4 stents were anchored by a second stent, and 7 stents were rem oved percutaneously. In the 2 failed cases, the stents were retrieved using a minor surgical procedure. There were 2 minor groin hematomas but no seco ndary complications during a median follow-up of 26.2 months (range 1-62). Conclusions: Percutaneous management of migrated or maldeployed endovascula r stents is highly effective with few complications. On the basis of our fi ndings, these techniques should be considered the therapy of choice.