Here’s a nice case showing that a tunneled hemodialysis catheter can be placed through the intersticies of fully intimalized stents to preserve venous access if necessary. In this instance the right Internal Jugular vein was jailed by a subclavian stent placed two years prior. The patients right forearm fistula and subsequent right arm AV graft had both fully failed and preservation of left arm veins for a future graft was paramount. The catheter advanced easily through the stent after the intersticies were expanded with serial dilators over an Amplatz wire with minimal resistance.
Case CreditsImages and content graciously provided by:
Jason E. Himmel, MD