Have no fear, IR is here: A case of right brachiocephalic vein /svc recanalization for port placement

Abstract

A patient with a history of cystic fibrosis and bilateral lung transplant presented internal jugular port placement for extracorporeal photopheresis in the setting of acute rejection. Imaging demonstrated chronic calcific stenosis of the right brachiocephalic vein and superior vena cava (SVC). Standard access with sheath advancement was attempted and unsuccessful. Ultimately, a pair of stiff glidewires were inserted through each lumen and provided sufficient support to advance the catheter into position. This case describes a simple technique to overcome recalcitrant central venous stenosis when conventional approaches may be impractical or contraindicated.