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J Vasc Surg Venous Lymphat Disord. 2022 Jan 10; doi: 10.1016/j.jvsv.2021.07.015. Epub 2022 Jan 10.

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

Journal of vascular surgery. Venous and lymphatic disorders

Dr Mohamed Hosny Sayed, Dr Murtaza Salem, Kush R Desai, Gerard J O'Sullivan, Stephen A Black

Affiliations

  1. Department of Vascular Surgery, Level 1 North Wing Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH.
  2. Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA.
  3. Department of Radiology, Galway University Hospital, Galway, Ireland.
  4. Department of Vascular Surgery, Level 1 North Wing Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH. Electronic address: [email protected].

PMID: 35026448 DOI: 10.1016/j.jvsv.2021.07.015

Abstract

INTRODUCTION: Percutaneous endovenous stenting has emerged during the last decade as the primary method of treating symptomatic venous outflow obstruction. A recognised complication of venous stenting is stent migration. The aim of this systematic review was to identify the number of cases reported in the published literature describing stent migration, to recognise risk factors that may be associated with this complication, and outcomes following migration.

METHODS: A review was conducted following MOOSE and PRIMSA guidelines and registered on PROSPERO. MEDLINE, EMBASE, and PubMed databases and key references were searched using specified keywords. All relevant data for primary procedure and subsequent presentation with stent migration was retrieved. Data was assessed as too low quality to allow for statistical analysis.

RESULTS: Between 1994 and 2020, 31 articles were identified comprised of 29 case reports and 2 case series providing data for 54 events of venous stent migration with 47/54 providing some data for stent used. Mean age of patients in who migration occurred was 50 years (range 19-88) and 57.6% (n=30) were male. Most reported cases were 60mm or less in length (38/46, 82.6%) and only 3 of the reports were stents greater than 14mm in diameter (3/47, 3.6%). None of the papers reported migration of stents of more than 100mm in length. In 85% of the migrated stent events, retrieval was attempted with 56% via an endovascular approach. The immediate outcome was satisfactory in 100% of the reported attempts whether by endovascular or open surgical approaches.

CONCLUSIONS: This literature review would suggest that the risk of migration is rare but may be underreported. The majority of reported cases are shorter and smaller diameter stents. The paucity of published data and the short term follow up provided suggest more formal data collection would provide a truer reflection of incidence however clear strategies to avoid migration need to be followed to prevent this complication from occurring.

Copyright © 2022. Published by Elsevier Inc.

Keywords: Venous; complications; migration; retrieval; right ventricle; stent

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