An attempt to treat symptomatic stenosis of the inferior vena cava in a pat
ient with metastatic liver disease was complicated by migration of a Wallst
ent into the right atrium. Effective palliation was achieved by insertion o
f a second stent, which was anchored by transhepatic insertion of a T-faste
ner into the intracaval stent. This anchoring maneuver was performed safely
under sonographic and fluoroscopic guidance.