medigraphic.com
SPANISH

Revista Mexicana de Urología

Organo Oficial de la Sociedad Mexicana de Urología
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2022, Number 5

<< Back Next >>

Rev Mex Urol 2022; 82 (5)

Multidisciplinary approach for ureteral stent intravascular migration: a case report

Bernal-Gómez A, Gómez-Palomo F, López-Acón JD, Bonillo GMÁ
Full text How to cite this article

Language: English
References: 13
Page:
PDF size: 175.03 Kb.


Key words:

ureteral stent, inferior vena cava, intravascular migration, complication, case report.

ABSTRACT

Clinical case description: We report the case of a patient who underwent a double-pigtail ureteral stent (DPS) retrograde placement, following a complicated right renal colic. After two days with persisting pain and hematuria, a CT-Scan revealed a proximal pigtail misplacement into the inferior vena cava (IVC). In a multidisciplinary approach, an endourological removal was performed, pulling the distal loop with a cystoscope, while the vascular surgery team performed femoral access and phlebography during and after the DPS removal to prevent bleeding from IVC. Abdominal access for laparotomy was ready, anticipating potential bleeding.
Relevance: DPS retrograde placement is a very frequent, usually uneventful procedure, but major complications may occur, such as the one described in the present case. It is important to know the risk of intravascular misplacement of the DPS, especially in cases of bad evolution or hematuria.
Conclusion: DPS intravascular migration is a rare but potentially severe complication. An early detection and a multidisciplinary collaboration between the urology and vascular surgery teams is paramount to perform a minimally invasive removal and prevent major events.


REFERENCES

  1. Ioannou CV, Velegrakis J, Kostas T, GeorgakarakosE, Touloupakis E, Anezinis P, et al. Cavalmigration of a ureteral J-stent after simultaneousureter and iliac vein perforation during itsplacement for obstructive pyelonephritis. IntAngiol. 2009;28(5):421–4.

  2. Sabnis RB, Ganpule AP, Ganpule SA. Migrationof double J stent into the inferior vena cava andthe right atrium. Indian J Urol. 2013;29(4):353–4. doi: https://doi.org/10.4103/0970-1591.120125

  3. Hastaoglu IO, Tokoz H, Kavlak E, Bilgen F.Double J ureteral stent displaced through theright ventricle. Interact Cardiovasc ThoracSurg. 2014;18(6):853–4. doi: https://doi.org/10.1093/icvts/ivu037

  4. Mao X-W, Xu G, Xiao J-Q, Wu H-F. Ureteraldouble J stent displaced into vena cava andmanagement with laparoscopy: A case reportand review of the literature. World J ClinCases. 2018;6(16):1160–3. doi: https://doi.org/10.12998/wjcc.v6.i16.1160

  5. Michalopoulos AS, Tzoufi MJ, TheodorakisG, Mentzelopoulos SD. Acute postoperativepulmonary thromboembolism as a result ofintravascular migration of a pigtail ureteralstent. Anesth Analg. 2002;95(5):1185–8, table of contents. doi: https://doi.org/10.1097/00000539-200211000-00011

  6. Falahatkar S, Hemmati H, GholamjaniMoghaddam K. Intracaval migration: anuncommon complication of ureteral Double-Jstent placement. J Endourol. 2012;26(2):119–21. doi: https://doi.org/10.1089/end.2011.0469

  7. Tang Z, Li D, Xiao L, Wan Y, Luo K, Huang L,et al. Re: Intracaval migration: an uncommoncomplication of ureteral double-J stent placement.(From: Falahatkar S, Hemmati H, GholamjaniMoghaddam K. J Endourol 2012;26:119-121). JEndourol. 2012;26(8):1100–1; author reply 1102.doi: https://doi.org/10.1089/end.2012.0038

  8. Özveren B, Şahin A. Re: Intracaval Migration:An Uncommon Complication of UreteralDouble-J Stent Placement. Journal ofEndourology. 2013;27(8):1069–71. doi: https://doi.org/10.1089/end.2012.0656

  9. Marques V, Parada B, Rolo F, Figueiredo A.Intracaval misplacement of a double-J ureteralstent. BMJ Case Rep. 2018;2018:bcr-2017-221713. doi: https://doi.org/10.1136/bcr-2017-221713

  10. Tilborghs S, Vaganée D, De Wachter S, HoekxL. Intravascular double J stent migration: A casereport, review, and management algorithm.Urol Ann. 2019;11(1):93–7. doi: https://doi.org/10.4103/ua.ua_52_18

  11. Hu C, Zhu A, Zhu X, Liang T, Lu X. Endovascularremoval of a misplaced ureteral stent in thevena cava: a complication of ultrasound-guidedpercutaneous nephrolithotomy. Clin Case Rep.2020;9(1):77–9. doi: https://doi.org/10.1002/ccr3.3429

  12. Jiang C, Fu S, Chen J, Chen Y, Chen D, MishraP, et al. Migration of a double J stent into theinferior vena cava: A case report. Medicine(Baltimore). 2019;98(20):e15668. doi: https://doi.org/10.1097/md.0000000000015668

  13. Liu L, Cao G, Huang G, Du J, Li W, Li Q. Adouble-J stent misguided by zebra guidewireinto ileum: A case report and literature review.Urol Case Rep. 2022;44:102128. doi: https://doi.org/10.1016/j.eucr.2022.102128




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Mex Urol. 2022;82