Treatment of superior vena cava syndrome with kissing brachiocephalic stents and exchange of pacemaker leads.

ABSTRACT

Superior vena cava syndrome is an uncommon but challenging complication of patients undergoing hemodialysis through upper extremity access as well as of patients with indwelling pacemakers. This case report and Video demonstrate the multidisciplinary management of a complex patient with hemodialysis access and indwelling pacemaker for whom multiple attempts at balloon angioplasty for superior vena cava syndrome failed. A joint procedure between vascular surgery and cardiac electrophysiology teams was performed to exchange the pacemaker leads and to place bilateral kissing stents in the brachiocephalic veins. The patient tolerated the procedure well and had no recurrence of symptoms.