A rare case of revascularization of chronically occluded brachial artery with an old-long-segment thrombus by using Fogarty adherent clot catheter and ultrasound guidance.

Arterial old-long-segment thrombus is a difficult-to-handle complication in brachio-cephalic fistula, leading to totally chronic occlusion, fistula dysfunction, and potential upper limb ischemia. This case study presented the successful clinical experience of using Fogarty adherent clot catheter to remove an old-long-segment thrombus (15 cm) in the brachial artery, which was guided by ultrasound. The procedure resulted in long-term patency of the arteriovenous fistula with no early or delayed complications. This study highlighted the effectiveness, safety, and practicality of this procedure, offering the advantages of brachial artery revascularization to prevent further ischemic complications, preserve valuable vascular access, and maintain full functionality, minimal trauma, and reduced radiation exposure.