George H. Meier, MD, Jeffrey S

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Presentation transcript:

Initial experience with venous stents in exertional axillary-subclavian vein thrombosis George H. Meier, MD, Jeffrey S. Pollak, MD, Melvin Rosenblatt, MD, Kevin W. Dickey, MD, Richard J. Gusberg, MD Journal of Vascular Surgery Volume 24, Issue 6, Pages 974-983 (December 1996) DOI: 10.1016/S0741-5214(96)70043-5 Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Initial diagnostic venogram of left arm in initial patient, a 17-year-old woman with left arm pain and swelling of several days duration. Subclavian vein is acutely thrombosed, with extensive collateral formation to jugular system. Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 In the same patient, after 22 hours of urokinase infusion, digital subtraction venogram demonstrates patent subclavian vein with significant residual obstruction. Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 PTA of residual stenosis (with a 10 mm by 5 cm balloon inflated to 5 atmospheres) demonstrates persistent waist at stenosis that never completely dilated (paired arrows). Subsequently, 70% residual narrowing was present. Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Completion venogram after PTA and venous stent placement using a 12 mm by 9 cm Wallstent. Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 In this same patient at 8 months' follow-up, fracture of venous stent is demonstrated by chest roentgenogram (arrow). Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Digital subtraction venogram in same patient at 30 months' follow-up demonstrates venous patency with fractured stent (arrow). Presence of collateral veins suggests hemodynamically significant restenosis. Journal of Vascular Surgery 1996 24, 974-983DOI: (10.1016/S0741-5214(96)70043-5) Copyright © 1996 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions