Computed Tomography-guided Sharp Needle Venous Recanalization of Chronic Clot
Journal Title: American Journal of Interventional Radiology - Year 2018, Vol 2, Issue 1
Abstract
This article outlines a case performed at our instutition that involved direct sharp recanalization of the superior vena cava (SVC) as a way to bypass chronic venous thrombus using a combination of ultrasound and CT guidance. The case is of a patient requiring a Denver shunt for chronic chylous ascites. His prior shunts placed in the right internal jugular and subclavian veins became thrombosed repeatedly. His left subclavian vein was resected with subsequent occlusion of the graft. The brachiocephalic vein was narrowed likely after his mediastinal lymph node dissection. Revision of the Denver shunt could therefore only be done by directly cannulating into the proximal SVC away from the thrombosed right internal jugular vein. This case outlines the use of CT as an adjunct to standard ultrasound or fluoroscopic guided sharp needle recanalization which has not previously been described in the literature and offers clinicians an additional tool to help treat long-segment thrombus and preserve important vessels for venous access.
Authors and Affiliations
Shiraz Rahim, Nami Azar, Jon Davidson, Yasmine Ahmed
Keywords
Related Articles
- EP ID EP365734
- DOI 10.25259/AJIR-5-2017
- Views 136
- Downloads 0
Transcatheter Chemoembolization of a Hepatocellular Carcinoma Utilizing Lipiodol through the Pancreaticoduodenal Arcade: A Case Report
This case report describes the chemoembolization of a small hepatocellular carcinoma employing a lipiodol drug delivery system utilizing a novel arterial pathway. Because the target lesion was precariously located adjace...
Classification and Current Treatment of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is an aggressive primary liver cancer that arises in a background of hepatic cirrhosis. In the United States, HCC has been increasing due to an increasing prevalence of the Hepatitis C viru...
Partially Covered Transjugular Intrahepatic Portosystemic Shunt Endograft for Repair of a Primary Aortoenteric Fistula
Aortoenteric fistulae (AEF) are a rare cause of life-threatening gastrointestinal hemorrhage. AEF are divided into primary and secondary types. Secondary fistulae are more common and occur after prior aortic intervention...
Transjugular Intrahepatic Portosystemic Shunt Creation in Situs Inversus Totalis - A Case Report
We describe the third case of successful transjugular intrahepatic portosystemic shunt creation for the treatment of refractory ascites due to cirrhosis in a known case of situs inversus totalis.
Revascularization of chronic occlusive disease of a right pulmonary artery graft
Anomalous aortic origin of the left coronary artery (AAOLCA) is a rare occurrence. This anomaly may lead to myocardial ischemia and, therefore, surgical repair is recommended to improve long-term survival in these patien...