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Case Reports
. 2025 Apr 2;30(7):103394.
doi: 10.1016/j.jaccas.2025.103394.

Aortic Displacement of a Pulmonary Stent: Multidisciplinary Approach to Treat a Rare Complication

Sorin S Popescu  1 , Alexandru I Duta  2 , Fabian J Jacob  3 , Karl H Kuck  2 , Roland R Tilz  4
Affiliations
Case Reports

Aortic Displacement of a Pulmonary Stent: Multidisciplinary Approach to Treat a Rare Complication

Sorin S Popescu et al. JACC Case Rep. .

Abstract

Background: Pulmonary vein (PV) stenosis is a rare complication of radiofrequency-based pulmonary vein isolation (PVI). Its therapy consists of PV stenting.

Case summary: A 67-year-old woman underwent a thoracic computed tomography scan after left PV stenting for stenosis after PVI. The scan revealed the stent missing in the left inferior PV and worsening high-grade stenosis. An abdominal computed tomography scan identified the displaced stent in the aorta, just above the aortoiliac bifurcation. Digital subtraction angiography also revealed moderate stenosis in the right common iliac artery. A double stenting procedure of the aortoiliac bifurcation using the kissing stents technique was performed, securing the PV stent and treating the common iliac artery stenosis. Follow-up on the displaced stent was favorable.

Discussion and take-home message: PV stent systemic displacement is a rare but life-threatening complication of PV stenting. Kissing stents technique is effective to secure the displaced stent in the aortoiliac bifurcation.

Keywords: atrial fibrillation; stenosis; stents.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Tilz is a consultant for Boston Scientific, Philips, Medtronic Biosense Webster, and Abbott Medical; is a shareholder and medical director by Active Health; had received speaker honoraria from Boston Scientific, Biotronik, Biosense Webster, Abbott Medical, Lifetech, and Pfizer; has received research grants from Abbott, Biotronik, Medtronic, Biosense Webster, and Lifetech; and has received travel grants from Abbott, Biosense Webster, Boston Scientific, Medtronic, and Philips. Dr Popescu is a medical consultant by Active Health; and has received travel grants and congress grants from Lifetech and educational grants and a speaker grant from Abbott Medical. Dr Duta has received an educational grant from Medtronic. Dr Kuck reports grants and personal fees from Abbott Vascular, Medtronic, and Biosense. Dr Jacob has reported that he has no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Thoracic Computed Tomography Scan Thoracic computed tomography scan showing the left superior pulmonary vein with normal contrast and position of the stent (red arrow) in transversal (A) and coronal (B) view and the high-grade, short stenosis of the left inferior pulmonary vein (red arrow), with no visible stent at this level in transversal (C) and coronal (D) view.
Figure 2
Figure 2
Abdominal Computed Tomography Scan Abdominal computed tomography scan in frontal view showing the displaced stent in the abdominal aorta, superior to the aortoiliac bifurcation.
Figure 3
Figure 3
Aortic Digital Subtraction Angiography Aortic digital subtraction angiography preprocedural (A), showing the displaced stent in the abdominal aorta (red arrow) and the moderate atherosclerotic stenosis of the right common iliac artery (red star), and postprocedural (B and C) showing the position of the 2 implanted stents (outlined in blue and red) and the result after right common iliac artery stenting.
Visual Summary
Visual Summary
Chronologic Presentation of the Case AF = atrial fibrillation; AV = atrioventricular; CB = cryoballoon; CIA = common iliac artery; CT = computed tomography; CTI = cavotricuspid isthmus; LIPV = left inferior pulmonary vein; LPV = left pulmonary veins; LSPV = left superior pulmonary vein; PV = pulmonary vein; PVI = pulmonary vein isolation; RF = radiofrequency.
See this image and copyright information in PMC

References

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