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A 'Train-Track' Technique in Anatomic Reconstruction of SVC Bifurcation Complicated by Cardiac Tamponade: An Introspection
- Source :
- Cardiovascular and interventional radiology. 40(4)
- Publication Year :
- 2016
-
Abstract
- This report describes a stenting technique used to anatomically reconstruct superior vena cava (SVC) bifurcation in a patient with benign SVC syndrome. After recanalizing the SVC bifurcation, we exchanged two 0.035-in. wires for two 0.018-in. wires, deployed the SVC stent over these two wires (“train-track” technique), and stented each innominate vein over one wire. However, our decisions to recanalize both innominate veins, use the “buddy-wire” technique for SVC dilation, and dilate the SVC to 16 mm before stent deployment likely contributed to SVC tear, which was managed by resuscitation, SVC stent placement, and pericardial drainage. Here, we describe the steps of the train-track technique, which can be adopted to reconstruct other bifurcations; we also discuss the controversial aspects of this case.
- Subjects :
- medicine.medical_specialty
Superior Vena Cava Syndrome
Vena Cava, Superior
medicine.medical_treatment
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Stent deployment
Superior vena cava
Cardiac tamponade
medicine
Humans
Radiology, Nuclear Medicine and imaging
Innominate vein
Bifurcation
Pericardial drainage
business.industry
Endovascular Procedures
SVC SYNDROME
Stent
Middle Aged
medicine.disease
Surgery
Cardiac Tamponade
Female
Stents
Radiology
Cardiology and Cardiovascular Medicine
business
Angioplasty, Balloon
Subjects
Details
- ISSN :
- 1432086X
- Volume :
- 40
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Cardiovascular and interventional radiology
- Accession number :
- edsair.doi.dedup.....92f00a9babcec55f0d704209c963c89e