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Revista mexicana de urología
On-line version ISSN 2007-4085Print version ISSN 0185-4542
Abstract
BERNAL-GOMEZ, Adrián; GOMEZ-PALOMO, Francisco; LOPEZ-ACON, José Daniel and BONILLO GARCIA, Miguel Ángel. Multidisciplinary approach for ureteral stent intravascular migration: a case report. Rev. mex. urol. [online]. 2022, vol.82, n.5, e04. Epub Feb 13, 2023. ISSN 2007-4085. https://doi.org/10.48193/revistamexicanadeurologa.v82i5.868.
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.
Keywords : ureteral stent; inferior vena cava; intravascular migration; complication; case report.