Covered Stents for Cephalic Arch Stenosis

A functional arteriovenous access is required to provide hemodialysis, which remains the most commonly used one for renal replacement therapy worldwide. In the upper arm, a brachiocephalic arteriovenous fistula is created by surgically joining the cephalic vein and brachial artery at the elbow. The outflow segment of the cephalic vein near the shoulder is called the cephalic arch. Due to its anatomical location, the cephalic arch segment is prone to developing stenosis resulting in access dysfunction and thrombosis. The management strategy to treat cephalic arch stenosis (CAS) remains a clinical challenge. We report a case of severe CAS treated successfully with endovascular therapy.