Stenting Through a Portacath for Totally Occluded Superior Vena Cava in a Case of Non-Hodgkin’s Lymphoma

 Simultaneous venograms from above and below the complete obstruction of the superior vena cava. The sheath of the portacath is seen inside the right atrium (arrow). Multiple collaterals are seen draining.
A doubled-up angioplasty guidewire acted as a snare to hook the Terumo guidewire from the inferior vena cava. The arrow denotes the hooked-up Terumo guidewire.
Fully expanded balloon seen in the superior vena cava in the previously occluded area. A slight “waist” is seen in the lower part of the balloon (arrow).
Restoration of blood flow is shown in the superior vena cava through the stented area. The proximal part of the stent is seen inside the right atrium. Arrow denotes a slight residual “waist” after stent deployment.

Tejas M. Patel, MD, DM, Sanjay C. Shah, MD, DM, Alok Ranjan, MD, DM, MRCP, Hemant Malhotra, MD, DNB, Rajnikant Patel, MD, Anoop K. Gupta, MD, DM, DNB

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