65/f H/o rt IJV temporary cath 6m back later lt RC AVF was done Now has with AVF complete stenosis So planned for TCC

Couldn't cannulate right IJV due to Mid ijv complete block , left IJV also stenosis So Put a 18G jelco in right EJV & contrast to know the down path before planning a TCC

Plan

RAG by #nephrologist

Not to panic if ur wire gets looped or slipped in subclavian ➰➿〰️⚕️ Tried & done a TCC through a c/o completely thrombosed right IJV 🥷

Although after a long gap another successful #PercutaneousCAPDcatheterinsertion , more precision with USG & Fluoro Hopefully to do more in 2025

For the same reason didn't attempt thrombolysis/thrombosuction/plasty Found right EJV insufficient for TCC in him So went ahead for a left IJV TCC Next plan & right RC AVF Back up plan - CAPD explained 😊

Whats your plan??

On Doplr screen Lt BC AVF patnt but rest entire CV , C-arch, SCV cmplete thrombsd, Lt IJV, Lt EJV, Conflunce, BrCV, SVC r norml & patnt Rt IJV complt Stenosis wit chronc thrombosis, Rt EJV smal Rt SCV & BrCV normal & patnt Rt UL Veins norml Hw u mng dis in ur city at prsnt?

Morning Fun Run & Fitness session,, thoroughly enjoyed ,, #NIMSAlumniMeet #beyondnephrology

Had a wonderful time today, meeting all our great teachers, seniors, colleagues & juniors #nimsalumnimeet #nims @dwivedi03_rohan @Shashikirankb @ManuelSonu

Mr VD 70/F on MHD x 1yr, Lt RC AVF c/o reduced flows x 1-2m Fistulogram - severe stenosis Post plasty - restored adequate flow

58/f H/o IJV cannulations in past Right RC AVF primary failure On MHD x 4y via Right BC AVF had Right UL edema x 2-3m O/e right upper chest veins also visible & dilated 💉C.veno🩻

Left BC AVF in use x 3m Now comes with pulsatile swelling just around the anastomosis site x 1w

@sekhar76027051 Partial thrombus > Attempt crossing the lesion> balloon plasty

@DrSatiaMn Yes sir, all the major veins of right upper limb got thrombosed

BC AVF creation 2 weeks back O/e Poor thrill USG screen - anastomosis Flow+