A 63-year-old male patient had been treated by HD in the last 5 years via left brachiobasilic AVF. He presented with gradually increasing painful swelling of the left upper limb, a sign of VH. CT angiography documented left brachiobasilic vein stenosis with extensive collaterals in the upper limb. Under local anesthesia, the right common femoral artery access was obtained with 8 french arterial sheath. This was followed by 5 french micro venous sheaths in left basilic vein, distal to stenosis site via left common femoral venous access. Then a Swan-Ganz catheter was placed in the left brachial artery just proximal to fistula site, followed by inflation of the balloon, check angiogram showed patent fistula site with stenosis of basilic vein. Through dilator of 5 French sheath – 6, 8 cm × 5 cm pushable coils were placed in venous side just distal to fistula, followed by introduction of fibrin glue, 1 ml (1:2). Final check angiogram documented successful embolization. Also, in this case, a rapid disappearance of the edema occurred with a progressive resolution of the elephantiasis [].
A 55-year-old male with left BCF, had VH with extensive edema of upper limb. He was evaluated with upper limb CT angiography and found to have left subclavian thrombosis with central venous stenosis at the junction of IJV and subclavian. SL of left BCF was performed and limb edema disappeared in 72 h [].