Stent fracture in the left brachiocephalic vein.
A 68-year-old male hemodialysis patient presented with severe congestion in his left arm. Left arm venography showed a completely occluded left brachiocephalic vein. We chose a self-expandable stent for treating this vein. However, restenosis occurred once at 8 months and again after six additional months. The cause of the restenosis was considered to be a stent fracture. On the first restenosis, we performed redilation with a balloon; on the second restenosis, we chose stent-in-stent with a balloon-expandable stent. At least 9 months after the stent-in-stent procedure, there has been no edema in his left arm. Therefore, stent-in-stent is one of the useful strategies for stent fracture in central venous obstruction.
Wada
Masamichi
M
Division of Cardiovascular Medicine, Toho University Ohashi Medical Center Hospital, Tokyo, Japan. wadamasamichi@hotmail.com
Yamamoto
Masaya
M
Shiba
Masanori
M
Tsuji
Takahiro
T
Iijima
Raisuke
R
Nakajima
Rintaro
R
Yoshitama
Takashi
T
Hara
Hidehiko
H
Hara
Hisao
H
Tsunoda
Taro
T
Nakamura
Masato
M
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D016121:Brachiocephalic Veins / Q000473:pathology / Q000503:physiopathology; D003251:Constriction, Pathologic / Q000628:therapy; D004487:Edema / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D010690:Phlebography; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012008:Recurrence; D006435:Renal Dialysis / Q000009:adverse effects*; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency