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[Venous stent application with a simultaneous cubitofemoral approach]
J Link1, J Brossmann, S Müller-Hülsbeck
1Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität Kiel.
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|July 1, 1995
Summary
A novel transbrachial approach successfully restored central vein patency in patients with superior inflow obstruction, enabling transfemoral Wallstent placement. This technique effectively bypassed blockages, ensuring successful treatment without immediate complications.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Superior inflow obstruction due to central vein stenosis or occlusion presents a significant challenge for venous access.
- Transfemoral approaches are often limited by these obstructions.
Purpose of the Study:
- To evaluate the efficacy of a combined transfemoral and transbrachial approach for treating superior central vein obstruction.
- To facilitate successful stent placement in challenging venous anatomies.
Main Methods:
- Four patients with central vein stenosis/occlusion underwent an initial failed transfemoral guidewire passage.
- An additional transbrachial venous access was established to navigate the obstruction.
- A long guidewire was advanced from the transbrachial access, through the obstruction, and retrieved transfemorally.
- Wallstent placement was subsequently performed via the transfemoral route.
Main Results:
- Successful central vein patency was achieved in all four patients using the transbrachial approach.
- Successful transfemoral Wallstent application was accomplished in all cases post-guidewire manipulation.
- No peri-interventional or post-interventional complications were observed within a 2-day follow-up period.
Conclusions:
- The combined transfemoral and transbrachial approach is a viable strategy for managing superior central vein obstruction.
- This technique effectively overcomes guidewire passage limitations caused by stenosis or occlusion.
- It enables successful stent deployment in complex venous cases with a favorable safety profile.