SVC Syndrome After Hemodialysis

12 Y/O girl with past history of ESRD and frequent dialysis. She had progressive edematosis of head, neck and upper limbs from 2 years ago. She referred to me for evaluation of SVC syndrome because of difficult case for surgical approach.In past history she had an angiography from IVC and could not done anything. We tried from right jugular vein, right brachial and axillary vein for evaluation of upper circulatory system. In our mind we must open these ways for better drainage. But we had many problems during the procedure .