U-bent Viabahn stent graft in the main left pulmonary artery in a hemodialysis patient after asymptomatic migration: Percutaneous removal and technical considerations

Background: Stent grafts (SG) have gained the highest level of evidence for superior management over angioplasty of arteriovenous graft (AVG) venous outflow stenosis, which increases their use in hemodialysis patients. Migration to the heart and lungs is the most feared complication of SG of the venous system. Method: We present a previously unreported case of asymptomatic migration of a 10-cm-long Viabahn lodged in a U-shaped configuration in the main left pulmonary artery after AVG intervention in a 50 year old male hemodialysis patient. Results: Through a single femoral access percutaneous retrieval of migrated SG was accomplished. Technique of coaxial buddy snaring technique is described. Conclusion: Our technique may expand the endovascular likelihood of successful stent removal.