Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique

Parth Amin; Mel J Sharafuddin; Chad Laurich; Rachael M Nicholson; Raphael C Sun; Simon Roh; Timothy F Kresowik; William J Sharp

doi:10.1016/j.avsg.2011.10.005

Back

Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique

Journal article

Peer reviewed

Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique

Parth Amin, Mel J Sharafuddin, Chad Laurich, Rachael M Nicholson, Raphael C Sun, Simon Roh, Timothy F Kresowik and William J Sharp

Annals of vascular surgery, Vol.26(2), pp.276.e5-276.e9

02/2012

DOI: 10.1016/j.avsg.2011.10.005

PMID: 22304866

View Online

Abstract

This article presents the case of a 42-year-old man who presented with superior vena cava (SVC) syndrome due to fibrosing mediastinitis with multiple failed attempts at recanalization. We initially treated him with unilateral sharp needle recanalization of the right innominate vein into the SVC stump followed by stenting. Although his symptoms improved immediately, they did not completely resolve. Six months later, he returned with worsening symptoms, and venography revealed in-stent restenosis. The patient requested simultaneous treatment on the left side. The right stent was dilated, and a 3-cm-long occlusion of the left innominate vein was recanalized, again using sharp needle technique, homing into the struts of the right-sided stent. Following fenestration of the stent, a second stent was deployed from the left side into the SVC, and the two Y limbs were sequentially dilated to allow a true bifurcation anatomy (figure). The patient had complete resolution of his symptoms and continues to do well 6 months later.

Recurrence

Catheterization - instrumentation

Humans

Anticoagulants - therapeutic use

Male

Phlebography - methods

Superior Vena Cava Syndrome - therapy

Tomography, X-Ray Computed

Treatment Outcome

Mediastinitis - complications

Prosthesis Design

Vena Cava, Superior - diagnostic imaging

Brachiocephalic Veins - diagnostic imaging

Endovascular Procedures - instrumentation

Sclerosis - complications

Superior Vena Cava Syndrome - etiology

Aged

Stents

Superior Vena Cava Syndrome - diagnostic imaging

Details

Title: Subtitle: Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique
Creators: Parth Amin - Department of Surgery, University of Iowa, Iowa City, IA, USA. parth-amin@uiowa.edu
Mel J Sharafuddin
Chad Laurich
Rachael M Nicholson
Raphael C Sun
Simon Roh
Timothy F Kresowik
William J Sharp
Resource Type: Journal article
Publication Details: Annals of vascular surgery, Vol.26(2), pp.276.e5-276.e9
Publisher: Netherlands
DOI: 10.1016/j.avsg.2011.10.005
PMID: 22304866
ISSN: 0890-5096
eISSN: 1615-5947
Language: English
Date published: 02/2012
Academic Unit: Radiology; Surgery
Record Identifier: 9984051794102771

Metrics

22 Record Views

3 Times Cited - Web of Science