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DOI: 10.1055/s-0043-1763317
TIPS Stent Migration to the Left Pulmonary Artery
Background: Excessive shunting through TIPS can cause life-threatening hepatic encephalopathy and right heart failure. Therapeutic options include TIPS reduction and occlusion. Stent distal migration may occur as complication. Here we present a rare case of stent migration and its management.
Case: A 59-year-old female with HTN, CKD, and NASH-related liver cirrhosis with refractory ascites was presented. TIPS was done in November 2021. Follow-up after 6 months revealed ascites and patent TIPS with high velocity on US Doppler. TIPS revision performed in May 2022 and showed severe stenosis, treated with angioplasty using 8 mm balloon. After this intervention patient was still complaining of refractory ascites and developed right-sided heart failure. TIPS downsizing was decided. The procedure was done using 7 mm balloon expandable covered stent. One week after reduction, patient came to ER with acute confusion state. Incidental abdominal X-ray showed migrated stent at the left lower chest. Stent removal from right femoral vein using snare was performed successfully. TIPS occlusion was performed.
Discussion: TIPS stent migration is one of the uncommon complications after reduction, which can be managed through an endovascular approach without complications.
Publication History
Article published online:
09 February 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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