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Recanalisation of an axillary vein occlusion jailed by a migrated cephalic arch stent-graft using the TruePath chronic total occlusion drilling device

Authors
  • Patel, Ankur1
  • Chan, Shaun Xavier Ju Min1
  • Zhuang, Kun Da1
  • 1 Singapore General Hospital, Outram Road, Singapore, 169608, Singapore , Singapore (Singapore)
Type
Published Article
Journal
CVIR Endovascular
Publisher
Springer International Publishing
Publication Date
Jan 14, 2020
Volume
3
Issue
1
Identifiers
DOI: 10.1186/s42155-020-0098-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundStent placement in the cephalic arch is being used with increasing frequency. Late complications of bare metal and stent grafts in dialysis access, in particular stent migration, are often under-reported and can lead to compromise of future dialysis circuits.Case presentationA 52-year-old man developed acute arm swelling 2 days after creation of a left arm brachio-basilic arteriovenous graft. The axillary vein was found to be jailed by a previously deployed cephalic arch stent graft which had migrated into the subclavian vein. There was failure to cross through the fabric of the stent graft using conventional chronic total occlusion wires and techniques. A TruePath device was used successfully to cross through the fabric of migrated cephalic arch stent graft and recanalise the short subclavian-axillary vein occlusion.ConclusionThe adapted use of a drilling chronic total occlusion device to drill through the fabric of migrated stent graft was performed successfully to allow complete recanalisation of the occluded axillary vein.

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