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Cephalic arch stenosis

Case Takeaways

  • Symptomatic and recoil cephalic arch stenosis requires a durable solution to restore and maintain patency
  • Cephalic arch stenosis is a notoriously difficult area to treat in the dialysis circuit. High rates of treatment failure and recurrent stenosis are seen with venoplasty alone.
  • When venoplasty fails the GORE® VIABAHN® Endoprosthesis offers a durable solution as it conforms very well to the anatomical configuration of the arch without kinking
  • It is possible to accurately deploy a GORE® VIABAHN® Endoprosthesis in the cephalic arch without significant compromise to the axillary vein
  • Device introduction from the fistula access (as opposed to femoral access) provides more precise control during deployment and allows more accurate positioning as the GORE® VIABAHN® Endoprosthesis deploys distal – proximal
  • ESVS guidelines recommend that endovascular treatment with stent grafts should be considered for the treatment of cephalic arch stenosis (Recommendation 63)1

1. Schmidli, J. et al., Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS), European Journal of Vascular and Endovascular Surgery 2018 Jun;55(6):757-818