Figure 1. A–G were obtained from a 68-year-old man with superior vena cava syndrome. (A, B) Computed tomography demonstrates large soft tissue mass causing superior vena cava obstruction. (C, D) Intra-operative venogram demonstrates superior vena cava obstruction with a filling defect corresponding to the mass seen in the prior computed tomography study. (E, F) Live fluoroscopy with cone beam computed tomography confirms optimal positioning of the argon trans-jugular liver biopsy instrument (horizontal arrows) before biopsy samples were obtained. Note the presence of a retained guidewire from a prior vascular intervention (triangle arrow). Intravenous ultrasound is seen within the brachiocephalic vein (curved arrow). (G) Intra-operative venogram demonstrates relief of the superior vena cava obstruction after stenting.