Treatment of superior vena cava syndrome with kissing brachiocephalic stents and exchange of pacemaker leads

Cassius Iyad Ochoa Chaar; Navid Gholitabar; Issa Rezek; Randy Luciano; Jude Clancy

doi:10.1016/j.jvsv.2019.04.009

Treatment of superior vena cava syndrome with kissing brachiocephalic stents and exchange of pacemaker leads

J Vasc Surg Venous Lymphat Disord. 2020 Jan;8(1):143-144. doi: 10.1016/j.jvsv.2019.04.009. Epub 2019 Jun 21.

Authors

Cassius Iyad Ochoa Chaar¹, Navid Gholitabar², Issa Rezek³, Randy Luciano⁴, Jude Clancy⁵

Affiliations

¹ Section of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn. Electronic address: cassius.chaar@yale.edu.
² Section of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn.
³ Department of Surgery, Yale University School of Medicine, New Haven, Conn.
⁴ Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn.
⁵ Section of Cardiology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn.

PMID: 31231057
DOI: 10.1016/j.jvsv.2019.04.009

Abstract

Superior vena cava syndrome is an uncommon but challenging complication of patients undergoing hemodialysis through upper extremity access as well as of patients with indwelling pacemakers. This case report and Video demonstrate the multidisciplinary management of a complex patient with hemodialysis access and indwelling pacemaker for whom multiple attempts at balloon angioplasty for superior vena cava syndrome failed. A joint procedure between vascular surgery and cardiac electrophysiology teams was performed to exchange the pacemaker leads and to place bilateral kissing stents in the brachiocephalic veins. The patient tolerated the procedure well and had no recurrence of symptoms.

Keywords: Arteriovenous fistula; Pacemaker; Superior vena cava syndrome.

Publication types

Case Reports
Video-Audio Media

MeSH terms

Angioplasty, Balloon / instrumentation*
Arteriovenous Shunt, Surgical / adverse effects*
Cardiac Pacing, Artificial / adverse effects*
Device Removal*
Female
Heart Diseases / complications
Heart Diseases / diagnosis
Heart Diseases / therapy*
Humans
Kidney Failure, Chronic / diagnosis
Kidney Failure, Chronic / therapy*
Middle Aged
Pacemaker, Artificial*
Recurrence
Renal Dialysis*
Stents*
Superior Vena Cava Syndrome / diagnostic imaging
Superior Vena Cava Syndrome / etiology
Superior Vena Cava Syndrome / therapy*
Treatment Outcome