Minimally invasive removal of a dislocated stent from the right atriumSevere Tricuspid Regurgitation Secondary to Subclavian Vein Stent MigrationComplete atrioventricular block due to venous stent migration from innominated vein to right ventricle
patientx wrote:As to being informed, when this procedure first started in the U.S., there was no mention on TIMS about the possibility of a stent coming loose and getting into the heart. No one knew about this possible complication. (But there are published case reports where this did happen.) So, the doctors doing this procedure do not know all the possible risks, or aren't saying.
There are published case reports of it? Huh.
Also, Dr. Zamboni seems to have realized this is a possible complication:
The logical alternative would be stent insertion. However, we refrained from using this option due to the absence on the market of dedicated devices of the proper size and length. Adapting existing stents at the level of the IJVs could increase the risk of pulmonary migration and
displacement, thus affecting venous outflow from the upper extremity.
("A prospective open-label study of endovascular treatment of chronic erebrospinal venous insufficiency," Zamboni, et al)
The point isn't to scare people about stents. If that is the fix for MS, then so be it.
My thought on the same info is that, while people here did not anticipate such an outcome, now that it has happened we have far more awareness of this risk thanks to this site and others like it.
True, and I think that's one of the things that makes this site valuable. But I don't think it's a good idea for someone to believe he or she knows all the in and outs and possible complications based on this website. Unfortunately, I don't think a person can rely on an IR to tell him everything he needs to know about having angioplasty for MS, either.
I wonder how many people who read this website realize that a vein can tear during angioplasty, and the fix can be - a stent.
This would be the same as what drsclafani is saying when he talks about the risk of rupture during ballooning? Dr. Sinan has performed a large number of procedures with his supersized ballooning without rupture. My expectation is that this is a small but potentially real risk. Most people here seem more comfortable with stents than I have been! Although maybe that is changing, as more outcomes surface.
I don't know if this is the same thing that Dr. Sclafani was talking about or not. You're right this is probably a small risk, and that it is a real risk:Successful Emergency Stent Implantation for Superior Vena Cava Perforation During Malignant Stenosis Venoplasty
I was also told that this happened in one case of the liberation procedure (jugular vein) , and that a stent was inserted to make sure the hemorrhaging stopped.
Also from when I was researching the cutting balloon, it justified the 'controlled indents' of the cutting balloon by saying that all angio can create some small tearing. No biggie.
I'm not sure what you're basing that "No biggie" assessment on.
And this doesn't even start to address the issue of whether the procedure actually does something for MS.
Dr. Dake's paper that should've been published last fall (but wasn't) might have helped with that question. As it is we have the one paper by Zamboni.
Unless that paper included some neurological measures, or measures of MS symptoms, I don't see how it would have addressed the efficacy question.
As it is, we mainly have testimonials. It's been often stated here that people have to weigh the risks of the procedure versus the benefits. For some people who have been hit hard by MS, the choice is pretty easy. But for those trying to make an assessment, good data is really lacking, especially considering the complications that are coming to light.