PMC4921187_01
A. Superior vena cava venogram revealing the presence of thrombus at the more distal part of SVC at the level of brachiocephalic veins confluence (arrow). B. After selective catheterization of the left brachiocephalic vein, a large thrombus was revealed (arrow).
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Then, the guidewire was advanced to the left brachiocephalic vein and, after selective catheterization, the venogram through a vertebral catheter revealed total occlusion of the SVC at the level of the brachiocephalic veins confluence and the presence of a large acute thrombus in left brachiocephalic vein (Figs. 1A, B).
After rheolytic thrombectomy, the venogram revealed a partial recanalization of the left brachiocephalic vein and peripheral superior vena cava.
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Angiojet catheter through the whole length of the left brachiocephalic vein and peripheral SVC, the procedure was terminated because significant reduction in thrombus burden was observed angiographically. A postprocedure, repeat venogram revealed a partial recanalization of the two vessels (Fig. 2).
A. A stent (arrow) was deployed in the left brachiocephalic vein. B Venogram after stent deployment (arrow).
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At 3-month followup CT with intravenous contrast media, a patent left brachiocephalic vein (A, arrow) as well as superior vena cava and the stent in place (B, arrow) were imaged.
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