CardioVascular and Interventional Radiology

, Volume 42, Issue 1, pp 130–136 | Cite as

Radiofrequency Wire Recanalization of Chronically Occluded Venous Stents: A Retrospective, Single-Center Experience in 15 Patients

  • Bill S. MajdalanyEmail author
  • Natosha Monfore
  • Minhaj S. Khaja
  • David M. Williams
Technical Note Venous Interventions
Part of the following topical collections:
  1. Venous Interventions



Chronically occluded venous stents may be difficult to salvage, necessitating multiple approaches and adjunctive techniques. Radiofrequency wires have been used to cross chronic obstructions in a variety of settings. Herein, radiofrequency wire recanalization (RFWR) of chronically occluded venous stents is presented.

Materials and Methods

Fifteen patients (8 males; 7 females) aged 23–74 years (median 42 years) underwent prior venous stenting in the setting of venous occlusions. Seven had an underlying coagulopathy, three had May–Thurner syndrome, three had provoked deep venous thrombosis, one had a dialysis fistula, and one had pacer leads in situ. All indwelling venous stents were chronically occluded and symptomatic. Out of 15 patients, 13 (87%) had iliocaval venous stents, while two (13%) had superior vena cava and/or upper extremity venous stents. After failing conventional and blunt recanalization techniques, RFWR was performed to traverse the chronic occlusions. Technical success and complications were recorded.


Fifteen patients underwent 19 procedures. Twelve patients underwent one procedure, two patients had two procedures, and one patient had three procedures. RFWR alone was used in 12/19 (63%) procedures, while 7/19 (37%) required adjunctive sharp recanalization techniques. Technical success or crossing of the occlusion with flow restoration through the occluded segments was achieved in 17/19 (89%). One major and one minor complication occurred.


Radiofrequency wire recanalization is an effective adjunct to revise chronically occluded venous stents, potentially increasing procedural success in challenging cases.


Radiofrequency wire Baylis Chronic thrombosis Stent revision Stent occlusion Venous Venous recanalization Iliocaval recanalization 





Radiofrequency wire


Radiofrequency wire recanalization



This study was not supported by any funding.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

For this type of study, informed consent is not required.

Consent for Publication

For this type of study, consent for publication is not required.


  1. 1.
    Neglén P, Hollis KC, Olivier J, Raju S. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg. 2007;46(05):979–90.CrossRefGoogle Scholar
  2. 2.
    Razavi MK, Jaff MR, Miller LE. Safety and effectiveness of stent placement for iliofemoral venous outflow obstruction: systematic review and meta-analysis. Circ Cardiovasc Interv. 2015;8:e002772.CrossRefGoogle Scholar
  3. 3.
    Raju S, Neglen P. Percutaneous recanalization of total occlusions of the iliac vein. J Vasc Surg. 2009;50:360–8.CrossRefGoogle Scholar
  4. 4.
    Raju S, Tackett P Jr, Neglen P. Reinterventions for nonocclusive iliofemoral venous stent malfunctions. J Vasc Surg. 2009;49:511–8.CrossRefGoogle Scholar
  5. 5.
    Farrell T, Lang EV, Barnart W. Sharp recanalization of central venous occlusions. J Vasc Interv Radiol. 1999;10:149–54.CrossRefGoogle Scholar
  6. 6.
    Honnef D, Wingen M, Gunther RW, Haage P. Sharp central venous recanalization by means of a TIPS needle. Cardiovasc Interv Radiol. 2005;28:673–6.CrossRefGoogle Scholar
  7. 7.
    Dou E, Winokur RS, Trost DW, Sos TA, Sista AK. Transjugular liver access cannula as a guiding instrument for the recanalization of chronic venous occlusions. J Vasc Surg Venous Lym Dis. 2016;4:187–92.CrossRefGoogle Scholar
  8. 8.
    Guimaraes M, Schonholz C, Hannegan C, Anderson MB, Shi J, Selby B Jr. Radiofrequency wire for the recanalization of central vein occlusions that have failed conventional endovascular techniques. J Vasc Interv Radiol. 2012;23:1016–21.CrossRefGoogle Scholar
  9. 9.
    Guimaraes M, Uflacker A, Schonholz C, Uflacker R. Successful recanalization of bile duct occlusion with radiofrequency puncture wire techniques. J Vasc Interv Radiol. 2010;21:289–94.CrossRefGoogle Scholar
  10. 10.
    Tingerides C, Annamalai G, Comin JM, Kaduri S, Pugash R, David E. Percutaneous recanalization of iliac artery occlusions by radiofrequency perforation: initial experience. J Vasc Interv Radiol. 2016;27:68–72.CrossRefGoogle Scholar
  11. 11.
    Majdalany BS, Elliott ED, Michaels AJ, Hanje AJ, Saad WEA. Radiofrequency wire recanalization of chronically thrombosed TIPS. Cardiovasc Interv Radiol. 2016;39:1040–4.CrossRefGoogle Scholar
  12. 12.
    Omary RA, Bettmann MA, Cardella JF, et al. Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol. 2002;13(9 Pt 1):879–81.CrossRefGoogle Scholar
  13. 13.
    Khaja MS, Chick J, Schuman AD, et al. Fluoroscopic targeting of wallstents and amplatzer vascular plugs in sharp recanalization of chronic venous occlusions. Cardiovasc Intervent Radiol. 2017;40:1777–83.CrossRefGoogle Scholar
  14. 14.
    Williams DM. Iliocaval reconstruction in chronic deep vein thrombosis. Tech Vasc Interv Radiol. 2014;17(2):109–13.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Division of Vascular and Interventional Radiology, Department of RadiologyUniversity of Michigan Health SystemAnn ArborUSA

Personalised recommendations