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Balloon assisted stent deployment in the cephalic arch (BASCA)
1Section of Vascular and Interventional Radiology, Department of Radiology, University of Missouri- Columbia, One Hospital Drive, Columbia, MO 65212 USA.
Radiology Case Reports
|March 5, 2021
Summary
Cephalic arch stenosis often leads to arteriovenous access failure. A new technique safely deploys stent grafts in the cephalic arch, improving outcomes for patients with difficult anatomy.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Nephrology
Background:
- Cephalic arch stenosis frequently causes arteriovenous access dysfunction and failure.
- Balloon angioplasty alone yields unsatisfactory outcomes for cephalic arch stenosis.
- Stent grafts offer high patency rates but pose technical challenges in the cephalic arch.
Observation:
- Stent graft placement in the cephalic arch is technically demanding due to adverse anatomical angles.
- Deployment risks include axillary vein "jailing," limiting future access options and potentially causing venous edema.
- A novel technique for safe and effective stent graft deployment in the cephalic arch was developed.
Findings:
- The described technique allows for safe and effective stent graft deployment in the challenging cephalic arch.
- This approach addresses the risks associated with standard stent graft placement in this location.
- Successful application in a 65-year-old male patient demonstrates feasibility.
Implications:
- This technique may improve the success rates and long-term patency of arteriovenous access in patients with cephalic arch stenosis.
- It offers a solution to the limitations of current treatment options for this specific anatomical challenge.
- Potential to reduce complications like axillary vein occlusion and venous edema, preserving future access options.
