Migration of covered stents from hemodialysis A-V access to the pulmonary artery: percutaneous stent retrieval and procedural trends.

Details are presented of two patients with end-stage renal disease (ESRD) who recently experienced migration of a Viabahn covered stent from a peripheral hemodialysis A-V access to the right lower lobe pulmonary artery. Successful percutaneous retrieval was achieved in one patient using a dual snare approach, facilitated by ex vivo product testing. The second patient was managed conservatively. A review of the institution's A-V access salvage procedures, indicated a concomitant trend toward greater use of stent-assisted procedures, and a higher utilization of covered versus uncovered stents.

Ulnar artery cannulation for coronary angiography and percutaneous coronary intervention: case reports and anatomic considerations.

Transradial artery cannulation is a useful alternative approach to the performance of diagnostic and interventional coronary procedures. However, its utility can be limited by incomplete palmar collateral support, access site failure, and anatomic variations. We report on five patients in whom percutaneous cannulation of the ulnar artery was primarily chosen, based on preprocedure examination, for coronary angiography in three patients and percutaneous coronary intervention in two others. The transulnar artery approach to coronary procedures is feasible and may be preferable in selected cases. Anatomic considerations are discussed.