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Open Access
CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR
DOI: 10.1055/s-0045-1810007
Case Report

Direct-Puncture-Guided Sharp Recanalization Technique in a Case of Long-Segment Superior Mesenteric Vein Occlusion

Mehrshad Bakhshi 
1   Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
,
Alberto Aroca
2   Division of Interventional Radiology, Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada
,
Louis-Martin Boucher 
1   Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
2   Division of Interventional Radiology, Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada
› Author Affiliations
Funding None.
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Abstract

We describe the case of a moderately long chronic superior mesenteric vein (SMV) occlusion following Whipple procedure. Anticoagulation therapy and traditional recanalization techniques through retrograde approach, collateral inferior mesenteric venous vasculature, and recanalization upstream of the SMV occlusion via direct transabdominal puncture failed. Sharp recanalization downstream of the occlusion via retrograde approach, using the stiff end of a glidewire sharpened with a blade, with guidance from the tip of a catheter placed upstream of the occlusion as a target was successful. Our rendezvous technique, combined with use of orthogonal views, allowed for increased precision and decreased risk of catastrophic extravasation.

Keywords

mesenteric venous thrombosis - sharp recanalization - superior mesenteric vein - occlusion

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Written consent for publication was obtained from the individual.




Publication History

Article published online:
29 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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