@article { author = {Heidari, Ramin and Ghadrdoost, Behshid and Behjati, Mohaddeseh}, title = {Interventional Angioplasty, a Growing Therapeutic Approach to the Superior Vena Cava Obstruction in the Presence of Hemodialysis Catheters: A Report of Two Cases}, journal = {Iranian Heart Journal}, volume = {20}, number = {1}, pages = {64-66}, year = {2019}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The long-term resistance of indwelling hemodialysis catheters leads to the developmentof the superior vena cava (SVC) syndrome due to the obstruction of the dialysis catheters. Themanagement of these cases needs technically challenging interventional procedures usingballoon inflation or stent implantation at the SVC/right atrium junction. Hereby, we report 2cases of the SVC syndrome in the setting of hemodialysis catheters which were successfullytreated via interventional angioplasty.Case Presentation: The first case was a 57-year-old man who was referred to us with facial congestion,gradual loss of consciousness, and fever. The patient underwent emergent hemodialysis. Thesource of the fever was found to be an infected permacath in the left internal jugular vein. Heunderwent hemodialysis through a right-sided access catheter. Upon the termination of thefever, the jugular access was exited and an arteriovenous fistula (AVF) was implanted in theright arm. After a while, the patient experienced swelling in the right arm. Finally, heunderwent angioplasty on the occluded AVF. On follow-up, the arm swelling had fadedgradually. The second case was a 60-year-old man who was referred to us with a diagnosis ofunder-dialysis. On admission, the patient’s permacath was removed and an AVF was implantedin his right arm to replace a dysfunctional AVF previously inserted in his left arm. After thematuration of the right arm’s AVF, the patient underwent regular hemodialysis sessions withoutcomplications. After 1 year, under-dialysis occurred again. On venous angiography, a cut-downvenous drainage from the origin of the brachiocephalic vein up to its entry into the right atriumwas seen.Conclusions: Interventional angioplasty is a therapeutic approach to the SVC obstruction in thepresence of hemodialysis catheters.}, keywords = {Superior vena cava obstruction,Interventional angioplasty,Hemodialysis,Catheter}, url = {http://journal.iha.org.ir/article_82795.html}, eprint = {http://journal.iha.org.ir/article_82795_9744c6ed3e8c4c973ce280a0ca5eb352.pdf} }