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Needle Recanalization of Chronic Venous Total Occlusions 

Needle Recanalization of Chronic Venous Total Occlusions
Chapter:
Needle Recanalization of Chronic Venous Total Occlusions
Author(s):

Adam N. Plotnik

, and Stephen Kee

DOI:
10.1093/med/9780199986071.003.0032
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date: 30 September 2020

Recanalization of chronic venous occlusions is often difficult. Sharp recanalization of occluded central veins was first described in 1996, with subsequent further variations reported in the literature. The needle recanalization of chronic venous total occlusions (NRCVTO) technique may be employed where standard initial techniques have failed. Initial efforts to cross the occlusion should always begin with an angled or straight 0.035-in. glidewire together with a 4 Fr diagnostic catheter. The NRCVTO technique employs the use of a trans-septal needle together with a 0.014-in. guidewire. A target is then provided in the vessel distal to the occlusion in the form of a 4 Fr 10-mm snare, which is usually placed via a transfemoral or, less commonly, transhepatic approach.

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