Stent migration and folding in the subclavian vein during subclavian hemodialysis catheter placement.

The role of stent placement in hemodialysis (HD) access intervention continues to evolve. As more stents are placed, new and unusual complications are coming to light. We describe a case in which an unsuccessful attempt to place a left subclavian dialysis catheter resulted in the inadvertent migration and folding of a previously deployed subclavian stent. Attempts to remove the stent with a snare were unsuccessful. Patency was restored to the access circuit by placing a new stent through the struts of the folded one. Clinical vascular practice guidelines for vascular access on the use of fluoroscopy for temporary HD catheter placement may need to be re-evaluated with the reported increase in stent placement in the US HD population.