• T Farrell, E V Lang, and W Barnhart.
• Department of Radiology, University of Iowa College of Medicine, Iowa City, USA.
• J Vasc Interv Radiol. 1999 Feb 1; 10 (2 Pt 1): 149-54.

PurposeTo describe a sharp puncture technique for recanalization of chronic central venous occlusions that could not be traversed by a guide wire.Materials And MethodsFive patients presented with six longstanding central venous occlusions that could not be traversed with a guide wire after thrombolysis. The occlusions occurred following radiation for lung carcinoma (n = 2) and indwelling venous catheters (n = 4). The length of venous occlusion was determined by simultaneously advancing transbrachial and transfemoral catheters to the site of occlusion. Initially, a curved guiding catheter with a Rosch-Uchida needle and, in subsequent patients, a coaxial sheathed needle with a 21-gauge stylet were used for recanalization. The recanalized veins were then balloon dilated and stents were placed.ResultsWith use of this technique, recanalization was successful in five of the six occlusions. One occlusion was too long to traverse safely in one patient. Two patients were asymptomatic 16-18 months after the recanalization.ConclusionThis new technique offers an effective alternative to surgery in the treatment of central venous occlusion.

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