Iliac Stent Migration to the Right Ventricular Outflow Tract

Expanded experience with cardiovascular black blood cinematic rendering

Black blood cinematic rendering (BBCR) is a newly described preset for cinematic rendering, which creates photorealistic displays from volumetric data sets with the contrast-enhanced blood pool displayed as dark and transparent. That set of features potentially provides for enhanced visualization of endomyocardial and intraluminal pathology, as well as cardiac devices. The similarity of the images to black-blood magnetic resonance imaging (MRI) may allow for expansion of the evaluation of certain types of pathology into patient populations unable to undergo MRI. In the emergency setting, the rapid acquisition time and reasonable post-processing time make this technique clinically feasible. In this expanded experience, we demonstrate an expanded clinical experience with the BBCR technique, highlighting the applications for intraluminal cardiovascular evaluation, especially focused on current and potential emergency radiology applications.

Silent Migration of a Left Common Iliac Venous Stent to the Right Atrium: A Case Report and Review of Literature

In the past decade, percutaneous endovenous stenting has emerged as the primary procedure for treating symptomatic venous outflow obstruction. Stent migration is a rare but serious and well-recognized complication of venous stenting. Cardiopulmonary complications following stent migration can manifest in a number of ways, including damage to the valves, arrhythmias, endocarditis, tamponade, and acute heart failure. Both extracardiac and intracardiac dislodgement of stents may be treated with catheter-directed extraction, stent redeployment, or surgical extraction. The decision on the type of procedure depends on multiple factors including the location of the stent, the size and accessibility of the stent, the symptoms, the extent of damage to the vital structures, and the overall health of the patient. We present the case of a 68-year-old male who presented with tachycardia. On further evaluation and workup, he was found to have an iliac venous stent that had migrated to the right atrium.

Bilateral common iliac vein stent migration

Venous stent migration to the heart is considered to be a rare complication of a common procedure. Therefore, many physicians do not include this complication in their differential diagnosis. We explain why this complication is likely more common than currently thought and why it should be considered as a potential diagnosis. This case describes migration of bilateral iliac vein stents into the right ventricular outflow tract and right interlobar pulmonary artery. We provide multiple imaging modalities demonstrating the migrated stents. We believe radiologists should be cognizant of this complication and consider it as a potential diagnosis. Hopefully, this will create a greater awareness of this life-threatening complication of venous stent placement.

The Clinical Problem of Pelvic Venous Disorders

Pelvic venous disorders are inter-related pathologic conditions caused by reflux and obstruction in the pelvic veins. It can present a spectrum of clinical features based on the route of transmission of venous hypertension to either distal or caudal venous reservoirs. Imaging can help to visualize pelvic vascular and visceral structures to rule out other gynecologic, gastrointestinal, and urologic diseases. Endovascular treatment, owing to its low invasive nature and high success rate, has become the mainstay in the management of pelvic venous disorders. This article reviews the pathophysiology, clinical presentations, and diagnostic and therapeutic approaches to pelvic venous disorders.