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.