Stiff wire loop technique for the management of jailed iliac vein stents in a patient with phlegmasia

A barrier to the management of misplaced bare metal stents is navigating a wire without entangling the stent interstices. We report on a 79-year-old with phlegmasia cerulea dolens after iliac vein stenting. CT imaging revealed misplacement of the proximal stent into the hypogastric vein, jailing the external iliac vein prohibitive to restoring flow. After repeated wire entry through stent struts, a loop was created with a stiff wire to promote wire passage alongside the stent. Once wire access was accomplished, a secondary stent was placed in a kissing stent format.