PMC5977417_01
Contrast-enhanced computed tomographic (CT) scan with 3-dimensional reconstruction showing the stenosis.
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A contrast-enhanced CT scan with 3-dimensional reconstruction (Figure 1) revealed significant superior vena cava compression secondary to MF.
Intraoperative venograms via the right and left arm, respectively.
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Intraoperative venograms performed via the right and left arms confirmed pre-occlusive stenosis of the right internal jugular (IJ) and innominate veins and SVC with extensive collateral veins and type 4 SVCS according to the Standford Classification (Figure 2).
Recanalization of right IJ and innominate veins.
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A 12F sheath was inserted, and two 0.035-in hydrophilic guidewires (Glidewire Terumo, Somerset, NJ, USA) were manoeuvred in parallel past the venous obstruction (Figure 3).
Stenting of the superior vena cava and kissing stents in right IJ and innominate veins.
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The parallel stents extended beyond the initial part of the stent in the SVC (Figure 4).
Venograms showing complete patency after stenting.
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A venogram demonstrated complete coverage of the SVC bifurcation and patent right IJ and innominate veins and SVC without any extravasation (Figure 5).
Computed tomographic scan with 3-dimensional reconstruction before patient discharge.
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A CT scan confirmed stent patency at discharge and 1 year (Figure 6).