Pulmonary Artery Migration of a Peripheral Endovascular Stent Discovered Prior to Renal Transplantation: A Case Report
2020
Background: Arteriovenous fistulas and grafts are preferred access for hemodialysis. Outflow stenosis is a
common complication that can be managed with angioplasty and stenting. Stent placement can be
complicated by thrombosis, limited area of cannulation, fracture, and migration.
Objective: This case reports a rare complication of endovascular stents, namely stent migration to the
pulmonary artery in the setting of renal transplantation.
Methods: A 55-year-old woman with end stage renal disease secondary to diabetes mellitus on
hemodialysis via a left arm basilic vein transposition. She subsequently developed outflow stenosis that was
treated with a stent placement. She was admitted for deceased donor kidney transplantation and preoperative
x-ray showed migration of the stent into a segmental pulmonary artery. After a pre-operative,
multidisciplinary discussion between interventional radiology, cardiothoracic surgery, transplant
nephrology and transplant surgery, the decision was made to proceed with rental transplantation followed
by stent removal. Interventional radiology removed the stent on postoperative day two without
complication. She has not experienced any complications in the year following her transplantation.
Conclusion: Postoperative stent removal by interventional radiology is a feasible management option in
lieu of lifelong anticoagulation.
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