Multidisciplinary approach for ureteral stent intravascular migration: a case report

Authors

  • Adrián Bernal-Gómez Hospital Universitario La Fe, Valencia, España
  • Francisco Gómez-Palomo Hospital Universitario La Fe, Valencia, España
  • José Daniel López-Acón Hospital Universitario La Fe, Valencia, España
  • Miguel Ángel Bonillo-García Hospital Universitario La Fe, Valencia, España

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v82i5.868

Keywords:

Ureteral Stent, Complication, Intravascular Migration, 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.

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Published

2022-11-23

Issue

Section

Clinical cases