Brachiocephalic vein confluence stenosis treated by two Wallstents using Y technique.

Background: Patency of the central veins is mandatory for proper function of hemodialysis fistula created at the upper extremities.

Case Report: We present a case of dilatation of right brachiocephalic vein (RBCV) stenosis using a Wallstent implanted through the wall of another Wallstent, which had formerly been inserted into the left brachiocephalic vein and the superior vena cava (SVC). The left subclavian vein was subsequently permanently occluded which rendered the left upper extremity unsuitable for hemodialysis.

Transthoracic, harmonic mode, contrast enhanced color Doppler echocardiography in detection of restenosis after percutaneous coronary interventions. Prospective evaluation verified by coronary angiography.

Aims: To test the feasibility and accuracy of transthoracic, harmonic mode, contrast enhanced Doppler echocardiographic assessment of lesion severity after PCI treatment in native coronary arteries--the LAD, Cx and RCA.

Methods And Results: Prospective evaluation of 59 patients (66 arteries). Restenosis was diagnosed whenever maximal flow velocity at least doubled in comparison to the segment immediately proximal to the PCI site or when local velocity was at least 2 m/s.

Imaging of all three coronary arteries by transthoracic echocardiography. An illustrated guide.

Background: Improvements in ultrasound technology has enabled direct, transthoracic visualization of long portions of coronary arteries : the left anterior descending (LAD), circumflex (Cx) and right coronary artery (RCA). Transthoracic measurements of coronary flow velocity were proved to be highly reproducible and correlated with invasive measurements. While clinical applications of transthoracic echocardiography (TTE) of principal coronary arteries are still very limited they will likely grow.