PMC9034966_01
Thrombosed basilic vein.
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Angiogram showed that the basilic vein was thrombosed (Figure 1). We also noted a completely thrombosed basilic vein (Figure 1) during the first injection of radiocontrast and a partially clotted cephalic vein which was draining from the graft that drained the graft flow (Figure 2).
Outflow obstruction:cephalic vein stenosis and basilic vein thrombosis.
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We also noted a completely thrombosed basilic vein (Figure 1) during the first injection of radiocontrast and a partially clotted cephalic vein which was draining from the graft that drained the graft flow (Figure 2).
Outflow angioplasty.
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Angioplasty of the cephalic arch stenosis was performed (Figures 3 and 4).
Outflow final result.
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Angioplasty of the cephalic arch stenosis was performed (Figures 3 and 4).
Post cephalic vein thrombectomy/percutaneous angioplasty.
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To ensure patency of this iatrogenic fistula, we placed a covered stent 7 mm x 5 cm stent (Viabahn) at the site where the graft drains into the cephalic vein, and angiogram showed good flow from the graft into the cephalic vein (Figure 5).
Relook after 2 months:self recanalization of basilic vein with significant stenosis.
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We electively brought the patient two months later for readdressing the basilic vein thrombosis as the clot burden was much larger than the clot seen in the cephalic vein (Figure 6).
Patent graft to cephalic vein stent and basilic vein angioplasty.
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Once the outflow was established for the graft through the cephalic vein with creation of the iatrogenic fistula, we observed spontaneous resolution of the basilic vein thrombosis and we did angioplasty of the basilic vein (Figures 7 and 8 ).
Basilic vein postangioplasty.
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Once the outflow was established for the graft through the cephalic vein with creation of the iatrogenic fistula, we observed spontaneous resolution of the basilic vein thrombosis and we did angioplasty of the basilic vein (Figures 7 and 8 ). Angiogram after the angioplasty of the basilic vein showed excellent flow in the basilic vein all the way into the central veins (Figure 8).