Page 54 - Virtual Vascular Vol 6

Left brachiocephalic vein

Rightt brachiocephalic vein
Elastic recoil with residual

50% stenosis

Superior vena cava

40% stenosis

Post balloon angioplasty showed elastic recoil of the stenosis. A 16mm x 60mm stent
was deployed at the left brachiocephalic vein.

Completion central venogram showed satisfactory result. The SVC
40% stenosis was kept observed.

Clinically the thrill along the AVF has much improved after the balloon

angioplasty and stenting. The patient continues to have dialysis via needling
Of his left brachiocephalic AVF the next day. There was no increased in
venous pressure during dialysis and haemostais of his needling sites was

without difficulty.

The left brachiocephalic vein and SVC stenosis was due to injury by the

prolonged usage left central venous catheter for dialysis. During dialysis,
the catheter tip is actually flipping and hit the vein wall constantly,
inducing intimal injury and subsequently an inflammatory response

leading to progressive stenosis.

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