Percutaneous transluminal angioplasty of an in-stent re-stenosis of the right subclavian vein in a dialysis patient

Case contributed by Dr Sajoscha Sorrentino

Patient Data

Age: 75 years
Gender: Male

High grade in-stent restenosis. There are multiple collateral veins filling in in this venogram.

Post balloon angioplasty - good lumen restoration and disappearance of collateral venous filling.

Case Discussion

Central venous stenosis is a relatively common problem in patients on long term haemodialysis through an AV fistula in the upper limb and may be seen in up to 40% of patients. 

The clinical presentation may vary - poor flow rates at dialysis needing longer hours of dialysis, limb swelling etc.

Interventional radiology offers a good option of management of such cases either by percutaneous transluminal balloon angioplasty or stent placement. Post stenting there is a risk of in-stent restenosis due to high flows at the dialysis and at the AV fistula. In-stent restenosis can be treated by balloon angioplasty.

This case demonstrates the use of balloon angioplasty in treating in-stent restenosis.

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Case information

rID: 15130
Published: 24th Sep 2011
Last edited: 5th Nov 2019
Inclusion in quiz mode: Included