PMC6319534_01
Post plasty fistulogram demonstrating "apparent recalcitrant" stenosis which predominantly spasm
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Fig1
There was an "apparent" stenosis (Fig. 1) which was angioplastied then followed by severe spasm (Fig. 2). which was perceived by the operator to be recalcitrant stenosis. Gooseneck snare (ev3, Plymouth MN, USA) was manipulated until the stent was lassoed at about half way along the stent. Given the flexibility and potential collapsibility of the Viabahn stent it was over-sheathed carefully collapsing and gently retracting the captured stent to minimize potential vessel injury (Fig. 5a-c, Additional file 1).
a and b Immediate post stent deployment fistulogram demonstrating stent migration to cephalic arch
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Fig3
Following stent deployment, the stent migrated and stopped at the confluence of the cephalic vein and the subclavian vein (Fig. 3).
a: Images on the day the patient was brought in for stent retrieval. b: Pulmonary Angiogram demonstrating the stent in a segmental pulmonary arterial branch
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Fig4
Initial fluoroscopic image of the left shoulder region demonstrated the stent was absent from the final position documented the previous day indicating the stent had migrated further (Fig. 4a). Fluoroscopic scanning of the chest identified the stent to overlie the left lower lobe (Fig. 4a).
a and b: Demonstrates the Viabahn stent engaged around the midsection of the stent (a) and subsequently ensnared (b). c: The ensnared stent is "sheathed" over by the braided 12F sheath
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PMC6319534_01_42155_2018_7_Fig5_HTML.jpg
Fig5
Gooseneck snare (ev3, Plymouth MN, USA) was manipulated until the stent was lassoed at about half way along the stent. Given the flexibility and potential collapsibility of the Viabahn stent it was over-sheathed carefully collapsing and gently retracting the captured stent to minimize potential vessel injury (Fig. 5a-c, Additional file 1).
The snared stent outside the patient
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Fig6
The stent was retrieved intact (Fig. 6).