Iliac Vein Stent Migration to the Heart in Patients With Chronic Venous Insufficiency

In recent years, iliac vein stenting is more frequently performed for the treatment of chronic venous insufficiency. Although it has been described as a relatively safe procedure with high success rate, several cases of stent migration to the heart, causing significant morbidity and mortality, have been reported in the medical literature. Stent migration to the heart is a rare but life-threatening complication, which may lead to cardiac arrhythmias, valve injury, and even myocardial perforation. Therefore, urgent retrieval of the migrated stent is of paramount importance. Our purpose is to discuss indications for revascularization in chronic venous insufficiency, complications associated with venous stent placement, and the risk factors for venous stent migration. We have performed a literature search to assess the retrieval approach chosen in various cases of intracardiac migration of venous stents. The literature search has revealed both endovascular and surgical retrieval approaches as feasible options to consider. While the endovascular approach is identified to have the highest overall success rate as described in the literature, the surgical approach was preferred for complex cases where the stent has migrated across the tricuspid valve or into the pulmonary vasculature. Additionally, we also describe 2 cases of stent migration to the heart that presented to our institution within 24 hours of iliac vein stent placement.