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Recanalization of Chronic Central Venous Occlusions: Techniques to Cross Difficult Venous Occlusions 

Recanalization of Chronic Central Venous Occlusions: Techniques to Cross Difficult Venous Occlusions
Chapter:
Recanalization of Chronic Central Venous Occlusions: Techniques to Cross Difficult Venous Occlusions
Author(s):

Sreekumar Madassery

, and Bulent Arslan

DOI:
10.1093/med/9780199986071.003.0033
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date: 20 February 2020

With approximately 400,000 patients on hemodialysis in the United States alone, there are increasingly more patients who eventually develop central venous occlusions, mostly because of numerous central venous catheterizations and the placement of arteriovenous fistulas and grafts. With improving technical abilities to obtain central venous access for catheters and maintain fistula/graft patency, increasingly more patients present with signs of central venous stenosis/occlusion. For many, the underlying occlusion is chronic, with well-formed collateral vessels that have developed over time, thus allowing continued dialysis or asymptomatic function. However, for many patients there is a gradual progression of symptoms. This chapter discusses several techniques to cross chronic central venous occlusions.

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