PURPOSE: To report a rare, fatal complication of superior vena cava Wallstent implantation. CASE REPORT: A 59-year-old man presenting with superior vena cava syndrome caused by small-cell lung cancer underwent stent implantation of 2 kissing Wallstents >1.5 cm above the right atrium. Despite correct stent deployment, vessel perforation occurred in a section not encased by tumor, which led to fatal pericardial tamponade shortly after the procedure. Autopsy revealed perforation of a stent strut through the caval wall into the pericardial space. Anatomical and methodological reasons are discussed. CONCLUSIONS: The interventionist should be aware of this rare complication. Alternative stent designs avoiding the sharp ends of Wallstents and Palmaz stents should be considered.
PURPOSE: To report a rare, fatal complication of superior vena cava Wallstent implantation. CASE REPORT: A 59-year-old man presenting with superior vena cava syndrome caused by small-cell lung cancer underwent stent implantation of 2 kissing Wallstents >1.5 cm above the right atrium. Despite correct stent deployment, vessel perforation occurred in a section not encased by tumor, which led to fatal pericardial tamponade shortly after the procedure. Autopsy revealed perforation of a stent strut through the caval wall into the pericardial space. Anatomical and methodological reasons are discussed. CONCLUSIONS: The interventionist should be aware of this rare complication. Alternative stent designs avoiding the sharp ends of Wallstents and Palmaz stents should be considered.
Authors: Tamir Friedman; Keith B Quencer; Sirish A Kishore; Ronald S Winokur; David C Madoff Journal: Semin Intervent Radiol Date: 2017-12-14 Impact factor: 1.513