A Crushed and Totally Migrated Iliac Stent into the Abdominal Aorta: Look More Carefully!

Document Type : Case Report


1 Kocaeli University Medical Faculty, Department of Cardiology, Kocaeli, Turkey.

2 Kocaeli University Medical Faculty, Department of Cardiovascular Surgery, Kocaeli, Turkey.

3 Biruni University Medical Faculty, Department of Cardiology, Istanbul, Turkey.


Endovascular interventions are being increasingly used around the world. They are accepted as the primary approach to aortoiliac occlusive disease in most cases. Mainly, balloon-expandable stents are utilized to treat lesions, and some patients may develop complications. Stents may thrombose or migrate due to the force of the bloodstream or their inappropriate dimensions. Sometimes, the operator is to blame.
We herein describe a 67-year-old patient with a history of multiple endovascular interventions presenting to the emergency department with right foot pain. The patient underwent repeated angiography and endovascular intervention. In the last approach, diagnostic angiography revealed a crushed and migrated balloon-expandable stent in the abdominal aorta. The stent was removed surgically, and aorta-femoral bypass grafting was performed.
Endovascular maneuvers could lead to these complications; hence, the operator should exercise caution when working on previously implanted stents. Optimal stent expansion and awareness of this very uncommon complication are essential. (Iranian Heart Journal 2022; 23(4): 135-140)


  1. Civilini E, Melissano G, Baccellieri D, Chiesa R. Delayed upstream migration of an iliac stent. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. Aug 2007; 34(2):214-216.
  2. Shames ML, Sanchez LA, Rubin BG, Sicard GA. Migration of a bifurcated endovascular graft into an iliac aneurysm: endovascular salvage and future prevention--a case report. Vascular and endovascular surgery. Jan-Feb 2002; 36(1):77-82.
  3. Parham WA, Puri S, Bitar SR, Kern MJ. Management of iliac stent movement complicating peripheral vascular intervention: A rescue technique when stent deployment malfunctions. The Journal of invasive cardiology. May 2003; 15(5):277-279.
  4. Huynh KD, Mafi HM, Budtz-Lilly JW, Eldrup N. A symptomatic pseudoaneurysm caused by stent fracture in the external iliac artery. Oct 2013; 21(5):335-337.
  5. Higashiura W, Kubota Y, Sakaguchi S, et al. Prevalence, factors, and clinical impact of self-expanding stent fractures following iliac artery stenting. Journal of vascular surgery. Mar 2009; 49(3):645-652.
  6. Slonim SM, Dake MD, Razavi MK, et al. Management of misplaced or migrated endovascular stents. Journal of vascular and interventional radiology : JVIR. Jul-Aug 1999; 10(7):851-859.
  7. Kitchens C, Jordan W, Jr., Wirthlin D, Whitley D. Vascular complications arising from maldeployed stents. Vascular and endovascular surgery. Mar-Apr 2002; 36(2):145-154.
  8. Siani A, Accrocca F, Gabrielli R, Marcucci G. Acute lower limb ischaemia due to delayed upstream migration of an iliac stent. Interactive cardiovascular and thoracic surgery. Feb 2012; 14(2):231-233.
  9. Willfort-Ehringer A, Ahmadi R, Gruber D, et al. Arterial remodeling and hemodynamics in carotid stents: a prospective duplex ultrasound study over 2 years. Journal of vascular surgery. Apr 2004; 39(4):728-734.