Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Central Venous Occlusive Disease

Central venous occlusive disease is a common finding, especially in the dialysis population. The incidence of central venous occlusions is increasing, largely because of the expanded use of central venous catheters and pacer wires in the growing dialysis population. The clinical sequelae of central venous occlusions are highly variable and depend on the site of occlusion, the presence of collaterals, and the presence of an arteriovenous (AV) fistula on the affected side. Many patients have occult disease, but often the disease presents with failure of the AV access and swelling of the involved extremity, breast, neck, and face. Rarely, a pleural effusion may be present. This chapter discusses the use of Gore Excluder iliac limbs for some large central venous occlusions.