Download PDF
CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(02): 119-122
DOI: 10.1055/s-0041-1728996
Case Report

Revascularization of Chronic Iliac Vein Occlusion Using Balloon-Assisted Transseptal Needle Puncture Technique

Simon Long 
1   Department of Vascular and Interventional Radiology, University of California Irvine, Orange, California, United States
,
Patrick D. Sutphin
2   Department of Vascular and Interventional Radiology, GRB-290 Massachusetts General Hospital, Boston, Massachusetts, United States
,
Sanjeeva P. Kalva
2   Department of Vascular and Interventional Radiology, GRB-290 Massachusetts General Hospital, Boston, Massachusetts, United States
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objectives To evaluate the utility of a transseptal needle for balloon-assisted sharp recanalization of chronically occluded central venous structures.

Background Chronically occluded central veins are not an uncommon problem, which may arise due to a plethora of reasons. Traditionally, wire and catheter techniques are often used first in an attempt to reestablish flow. When these methods fail, more aggressive techniques are employed, such as sharp recanalization using the back end of wires, Teflon-coated wires, or Rosch–Uchida or Colapinto needles. However, utilization of transseptal needles, traditionally reserved for cardiac procedures, has rarely been described.

Methods Transseptal needle was utilized for balloon-assisted sharp recanalization after traditional wire and catheter techniques failed in revascularization of chronically occluded iliac veins.

Results Transseptal needle was utilized successfully in two cases in revascularization of chronically occluded central veins.

Conclusion Transseptal needle is a viable tool to add to the interventional radiologists’ armamentarium in reestablishing flow in chronically occluded central veins.

Keywords

sharp - recanalization - chronic


Publication History

Article published online:
18 May 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Horikawa M, Quencer KB. Central Venous Interventions. Tech Vasc Interv Radiol 2017; 20 (01) 48-57
    CrossrefPubMedGoogle Scholar
  • 2 Ferral H, Bjarnason H, Wholey M, Lopera J, Maynar M, Castaneda-Zuniga WR. Recanalization of occluded veins to provide access for central catheter placement. J Vasc Interv Radiol 1996; 7 (05) 681-685
    CrossrefPubMedGoogle Scholar
  • 3 Farrell T, Lang EV, Barnhart W. Sharp recanalization of central venous occlusions. J Vasc Interv Radiol 1999; 10 (2 Pt 1) 149-154
    CrossrefPubMedGoogle Scholar
  • 4 Goo DE, Kim YJ, Choi DL. et al. Use of a rosch-uchida needle for recanalization of refractory dialysis-related central vein occlusion. Am J Roentgenol 2010; 194 (05) 1352-1356
    CrossrefPubMedGoogle Scholar
  • 5 Gandhi AH, Wakefield TW, Williams DM. Recanalization of the intentionally interrupted inferior vena cava. J Vasc Surg 2015; 62 (03) 747-749
    CrossrefPubMedGoogle Scholar
  • 6 Ito N, Isfort P, Penzkofer T, Grommes J, Greiner A, Mahnken A. Sharp recanalization for chronic left iliac vein occlusion. Cardiovasc Intervent Radiol 2012; 35 (04) 938-941
    CrossrefPubMedGoogle Scholar
  • 7 Murphy TP, Webb MS. Percutaneous venous bypass for refractory dialysis-related subclavian vein occlusion. J Vasc Interv Radiol 1998; 9 (06) 935-939
    CrossrefPubMedGoogle Scholar
  • 8 Porter D, Rundback JH, Miller S. Sharp recanalization using a subintimal reentry device, angioplasty, and stent placement for severely symptomatic iliofemoral deep venous thrombosis secondary to congenital aplasia of the inferior vena cava. J Vasc Interv Radiol 2010; 21 (11) 1765-1769
    CrossrefPubMedGoogle Scholar
  • 9 Brountzos EN, Preza O, Kelekis A, Panagiotou I, Kelekis N. Recanalization of dialysis catheter-related subclavian vein occlusion using a re-entry device: report of two patients. Cardiovasc Intervent Radiol 2011; 34 (01) 207-211
    CrossrefPubMedGoogle Scholar
  • 10 Gupta H, Murphy TP, Soares GM. Use of a puncture needle for recanalization of an occluded right subclavian vein. Cardiovasc Intervent Radiol 1998; 21 (06) 508-511
    CrossrefPubMedGoogle Scholar
  • 11 Kalva SP, Salazar GM, Walker TG. Transjugular intrahepatic portosystemic shunt for acute variceal hemorrhage. Tech Vasc Interv Radiol 2009; 12 (02) 92-101
    CrossrefPubMedGoogle Scholar
  • 12 Gaba RC, Khiatani VL, Knuttinen MG. et al. Comprehensive review of TIPS technical complications and how to avoid them. Am J Roentgenol 2011; 196 (03) 675-685
    CrossrefPubMedGoogle Scholar
  • 13 Neglén P, Raju S. Intravascular ultrasound scan evaluation of the obstructed vein. J Vasc Surg 2002; 35 (04) 694-700
    CrossrefPubMedGoogle Scholar
  • 14 Alkhouli M, Rihal CS, Holmes DR Jr. Transseptal techniques for emerging structural heart interventions. JACC Cardiovasc Interv 2016; 9 (24) 2465-2480
    CrossrefPubMedGoogle Scholar
  • 15 Arabi M, Ahmed I, Mat’hami A, Ahmed D, Aslam N. Sharp central venous recanalization in hemodialysis patients: a single-institution experience. Cardiovasc Intervent Radiol 2016; 39 (06) 927-934
    CrossrefPubMedGoogle Scholar