Slippery Stents: A Case Report and Review of the Literature Describing Patients with May-Thurner Syndrome That Experienced Stent Migration

Table 1

Characteristics and outcomes of patients with MTS and stent migration.

Article	Description	Interventions and Complications	Outcome
(1) Elmahady S, et.al. [9]	65-year-old patient, with MTS stenting six months prior, presented with signs and symptoms of acute heart failure; transthoracic echocardiogram showed foreign body within right ventricle; transesophageal echocardiogram showed long stent straddled the tricuspid valve.	Percutaneous endovascular approach with snare was tried, it fractured the stent, leaving two segments. Surgical extraction was performed; as chords and leaflets were ruptured, valve replacement was done. Developed hemopericardium secondary to anticoagulation and small thromboembolic cerebellar stroke from atrial fibrillation.	Good prognosis at 8-month follow-up.
(2) Huang C, et al.; [12]	68 patients with MTS stenting; 65 underwent stent implantation and 3 underwent simple balloon angioplasty. 75 stents were used among 65 patients; in 1 patient (1.5%), migration of the stent to the right ventricle was reported.	For the patient who had a stent migration to the right ventricle, a snare was successfully used.	Developed iliac vein occlusion within a month. The patient declined intervention.
(3) Mullens W. et. al; [11]	55-year-old patient, who had two stents placed a year before in left iliac vein, presented with progressive dyspnea and fatigue. Transesophageal echocardiogram showed severe tricuspid regurgitation and two stents in the right ventricle.	Surgical removal of the stents was performed; as leaflets and chords were severely damaged, a tricuspid valvuloplasty was performed. No postoperative complications were reported.	Not reported.
(4) Ye K, et al.; [13]	205 patients with MTS underwent stent implantation. 227 stents were used. 17 patients required two stents for treatment, 3 (1.4%) of these patients required two stents due to migration of the first stent to the proximal segment of the compressed iliac vein.	For the 3 patients (1.4%) who had stent migration to the proximal segment of the compressed vessel, a second stent, that overlapped with the distal segment of the first stent, was used. No complications were reported.	Specific outcome for these 3 patients was not reported.
(5) Liu Z, et. al; [14]	48 patients with MTS underwent stent implantation. 49 stents were used. 3 (6.25%) patients required two stents for treatment as the initial stents migrated proximally.	For the 3 patients (6.25%) who had stents migration to the proximal segment of the compressed vessel, a second kissing stent was placed. No complications were reported.	Specific outcome for these 3 patients was not reported. No stent fractures or migrations were reported at 1-year follow-up.
(6) Hartung O, et. al.; [15]	89 patients with non-malignant obstructive iliocaval lesions, 52 of which were classified as MTS, underwent stent implantation. 2 (2.24%) patients had stent migration	One patient had a stent migrate into the retrohepatic IVC: it was pulled down into the infrarenal IVC, where it adopted a transversal position; another stent was deployed in the iliocaval junction.; The second patient’s stent was pulled back from the right atrium down to the left CFV with two Amplatz Goose Neck Snare kits (ev3, Inc, Plymouth, Minn), where it was retrieved surgically.	The patient was asymptomatic 33 months later, and the stent did not migrate.; The second patient had another stent accurately deployed 3 months later.