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Updated: Oct 8, 2025

Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
Published on: July 11, 2019
Surgical removal of a foreshortened right innominate vein Wallstent causing venous outflow obstruction
Kristin Schafer1, Eric Goldschmidt1, Andrew Seiwert2
1Department of General Surgery, University of Toledo, Toledo, OH, USA.
Objectives:
Stenting of central venous stenosis to preserve upper extremity hemodialysis access is well-described, though upper extremity complications secondary to these stents are less frequently discussed.
Methods:
We present the case of a 43-year-old male with a right brachiocephalic fistula who developed symptoms of venous hypertension following placement of a Wallstent for central venous stenosis. Workup demonstrated venous outflow obstruction secondary to stent foreshortening into the right subclavian vein.
Results:
The Wallstent was removed in a piecemeal fashion using an open surgical technique and a HeRO graft was placed for dedicated fistula outflow with complete relief of the patient's symptoms.
Conclusion:
In situations where a stent has migrated and endovascular removal is not possible, individual Wallstent fibers can be removed through a limited venotomy.
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