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Gopinathan Anil, MD, FRCR, Manish Taneja, MD, FRCR 

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1 Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter 
Gopinathan Anil, MD, FRCR, Manish Taneja, MD, FRCR  Journal of Vascular Surgery  Volume 52, Issue 4, Pages (October 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 These digital subtraction angiography (DSA) images demonstrate the anatomy of the right brachiocephalic vein occlusion: (A) shows the peripheral end of the occlusion, whereas the central end is seen on (B). The former is obtained by injection from the right arm and the latter through injection with the catheter tip in the left brachiocephalic vein. The double-headed arrow shows the extent of the occlusion (note the catheter placed at the patent end of the right subclavian vein [SCV] shown in the box). An indwelling pacemaker lead is also seen. CV, Cephalic vein; Pacemaker, pacemaker lead; SVC, superior vena cava. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 The (A) panel shows the Outback LTD re-entry catheter in the subclavian vein with the radio-opaque ‘L'ocator marker directed toward the catheter in the superior vena cava (SVC). Note the curved needle emerging through the lateral exit port of the catheter. The inch guidewire is traversing the revascularized track. ‘Target' refers to the catheter in the SVC that served as the reference while advancing the needle through the mediastinum. B, The completion venogram showing free transit of contrast through the revascularized (stented) brachiocephalic vein into the superior vena cava. There is no contrast extravasation into the mediastinum. Note the decompression of collaterals seen in Fig 1, A. RBCV, Right brachiocephalic vein, SCV, subclavian vein. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions


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