REGULAR CONTENT
Final ID
664
Type
Educational Exhibit-Poster Only
Authors
M Lessne1, A Hines1, B Holly2
Institutions
1Vascular & Interventional Specialists of Charlotte Radiology, Charlotte, NC, 2Johns Hopkins Hospital, Elkridge, MD
Purpose
To describe and illustrate techniques of central venous recanalization, ranging from optimal catheter and wire systems to sharp recanalization, radiofrequency wire recanalization, and use of the Surfacer® Inside-Out® Access Catheter SystemTo review limitations and complications from advanced central venous recanalization techniques
Materials & Methods
Occlusion of the central chest veins is a recognized complication in patients with prolonged central venous catheter use, upper extremity dialysis access, or in the setting of malignancy. Patients may present with ipsilateral arm swelling or symptoms of superior vena cava syndrome, including dyspnea, facial swelling, and light-headedness. Even in the asymptomatic patient requiring central venous access for medication or dialysis, central venous occlusion necessitates alterative access sites, such as trans lumbar, femoral, or trans hepatic which may have increased complication rates and patient discomfort. Traditional endovascular techniques are often sufficient to recanalize these venous occlusions, but often more advanced methods are required.
Results
In this presentation, we illustrate basic to advanced techniques of central venous recanalization. Case examples for each type of technique are provided, along with technical tips and tricks to demonstrate the safe and effective employment of these techniques. Limitations and pitfalls of these techniques will be discussed, including management of complications.
Conclusions
Even complex central venous occlusions can be recanalized using advanced endovascular techniques; however, appropriate technique selection and utilization is essential to maximize safety and efficacy.
Final ID
664
Type
Educational Exhibit-Poster Only
Authors
M Lessne1, A Hines1, B Holly2
Institutions
1Vascular & Interventional Specialists of Charlotte Radiology, Charlotte, NC, 2Johns Hopkins Hospital, Elkridge, MD
Purpose
To describe and illustrate techniques of central venous recanalization, ranging from optimal catheter and wire systems to sharp recanalization, radiofrequency wire recanalization, and use of the Surfacer® Inside-Out® Access Catheter SystemTo review limitations and complications from advanced central venous recanalization techniques
Materials & Methods
Occlusion of the central chest veins is a recognized complication in patients with prolonged central venous catheter use, upper extremity dialysis access, or in the setting of malignancy. Patients may present with ipsilateral arm swelling or symptoms of superior vena cava syndrome, including dyspnea, facial swelling, and light-headedness. Even in the asymptomatic patient requiring central venous access for medication or dialysis, central venous occlusion necessitates alterative access sites, such as trans lumbar, femoral, or trans hepatic which may have increased complication rates and patient discomfort. Traditional endovascular techniques are often sufficient to recanalize these venous occlusions, but often more advanced methods are required.
Results
In this presentation, we illustrate basic to advanced techniques of central venous recanalization. Case examples for each type of technique are provided, along with technical tips and tricks to demonstrate the safe and effective employment of these techniques. Limitations and pitfalls of these techniques will be discussed, including management of complications.
Conclusions
Even complex central venous occlusions can be recanalized using advanced endovascular techniques; however, appropriate technique selection and utilization is essential to maximize safety and efficacy.