case_images: PMC2921523_01
case_images: Left femoral venogram showing blocked external iliac vein. The vein that reforms distally passes along the right border of vertebra suggesting blocked lower end of inferior vena cava also
case_images: APC-3-77-g001.jpg
case_images: PMC2921523_01_APC-3-77-g001.jpg
case_images: F0001
case_images: A left femoral venogram showed external iliac vein occlusion and evidence of occlusion of lower end of IVC [Figure 1].
case_images: Short sheath through IJV, the tip of which is restraining the Rashkind balloon at SVC-RA junction
case_images: APC-3-77-g002.jpg
case_images: PMC2921523_01_APC-3-77-g002.jpg
case_images: F0002
case_images: Care was taken to keep the tip of the sheath beyond the superior vena cava - right atrial junction, so that injury to the SA node could be avoided during the 'pull' of the catheter [Figure 2].
case_images: Rashkind balloon in LA, which was passed through the PFO after pre-shaping it with pacemaker lead stylet
case_images: APC-3-77-g003.jpg
case_images: PMC2921523_01_APC-3-77-g003.jpg
case_images: F0003
case_images: Since the Rashkind balloon could not be negotiated to LA by standard maneuver through the FO ASD, the balloon was pre-shaped to 90  angulation by inserting a pacemaker lead stylet [Figure 3].
case_images: NuMED atrioseptostomy catheter in the left atrium passed over a 0.014" coronary wire, which is parked in left ventricle
case_images: APC-3-77-g004.jpg
case_images: PMC2921523_01_APC-3-77-g004.jpg
case_images: F0004
case_images: Over the wire a NuMED Z-5  SPT 002-9.5 mm atrioseptostomy catheter (NuMED, Inc.) was introduced and BAS was performed [Figure 4].