PDF(Pubmed)
Abstract：
BACKGROUND Stenting of the iliac vein remains one of the therapeutic options for the treatment of May-Thurner syndrome. Embolization of peripheral venous stents due to improper technique is a feared complication with an estimated incidence of 1% to 3%. Here we describe an interesting case of an embolized iliac vein stent in the right heart that was successfully extracted via a surgical approach. CASE REPORT A 52-year-old woman with a past medical history of hypertension, diabetes mellitus, and iliac vein stent (16×60 mm Zilver Vena) placement for May-Thurner syndrome presented for evaluation of shortness of breath, chest pain, and dizziness. A chest X-ray was performed, revealing a large stent in the cardiac silhouette. An echocardiogram showed a dense material across the tricuspid valve extending from the right atrium into the right ventricle. A percutaneous endovascular attempt to retrieve the stent was unsuccessful and led only to partial stent retrieval. An open sternotomy approach by a cardiac surgeon revealed the embolized stent across the tricuspid valve covered by endothelial tissue. The stent was successfully extracted without any need for tricuspid valve repair or replacement, followed by an uneventful postoperative recovery. CONCLUSIONS The percutaneous approach is the preferred initial option for the extraction of embolized iliac vein stents into the heart. However, when such an approach fails, the surgical approach remains a feasible option. As reported in this case, the surgical retrieval of a stent can be done without any need for either tricuspid valve repair or replacement.
摘要：
背景技术髂静脉的支架仍然是用于治疗梅-瑟纳综合征的治疗选择之一。由于技术不当而导致的周围静脉支架栓塞是一种令人恐惧的并发症，估计发生率为1％至3％。在这里，我们描述了一个有趣的案例，即通过手术方法成功提取了右心中的栓塞静脉支架。病例报告一名52岁女性，有高血压病史，糖尿病,May-Thurner综合征的髂静脉支架（16×60mmZilverVena）置入术用于评估呼吸急促，胸痛,和头晕。做了胸部X光检查,在心脏轮廓中发现了一个大支架。超声心动图显示，穿过三尖瓣的致密物质从右心房延伸到右心室。经皮血管内尝试取回支架失败，仅导致部分支架取回。心脏外科医生进行的开放式胸骨切开术显示，栓塞支架穿过被内皮组织覆盖的三尖瓣。支架成功拔出，无需进行三尖瓣修复或置换，术后恢复顺利。结论经皮穿刺取栓髂静脉支架进入心脏是首选的初始选择。然而,当这种方法失败时，手术方法仍然是一个可行的选择.据报道，在这种情况下，支架的手术取回可以在不需要修复或更换三尖瓣的情况下完成。
