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CardioVascular and Interventional Radiology

, Volume 42, Issue 2, pp 205–212 | Cite as

Approach, Technical Success, Complications, and Stent Patency of Sharp Recanalization for the Treatment of Chronic Venous Occlusive Disease: Experience in 123 Patients

  • Joseph L. McDevitt
  • Ravi N. Srinivasa
  • Joseph J. Gemmete
  • Anthony N. Hage
  • Rajiv N. Srinivasa
  • Jacob J. Bundy
  • Jeffrey Forris Beecham ChickEmail author
Clinical Investigation Venous Interventions
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To report the technical success and complications following sharp recanalization of chronic venous occlusions.

Materials and Methods

A total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.5 ± 17.5 years (range 19–90 years), underwent sharp recanalization of chronic venous occlusions. The etiologies of occlusion were chronic deep venous thrombosis (n = 43; 35.0%), prior central venous access (n = 39; 31.7%), indwelling cardiac leads (n = 21; 17.1%), and occluded venous stents (n = 20; 16.3%). The sites of venous occlusion included 59/123 (48.0%) thoracic central veins, 37 (30.1%) non-thoracic central veins, and 27 (22.0%) peripheral veins. Median length of occlusion was 3.2 ± 1.4 cm (range 1.3–10.9 cm).

Results

Sharp recanalization was most commonly attempted with transseptal needles in 108/123 (87.8%), with a mean number of 1.2 ± 0.4 crossing devices per patient (range 1–4 devices). Targeting devices included a loop snare (n = 92; 74.8%), partially deployed Wallstent (n = 21; 17.1%), partially deployed Amplatzer vascular plug (n = 8; 6.5%), and an angioplasty balloon (n = 3; 2.4%). Technical success was achieved in 111 (90.2%) patients. There were 3 (2.4%) severe, 1 (0.8%) moderate, and 7 (5.7%) minor adverse events. Severe adverse events included 1 case each of pericardial tamponade, hemothorax, and inferior vena cava filter occlusion. 88 (71.5%) patients had venous stents placed; at the last follow-up examination, 68/86 (79.0%) stents were patent.

Conclusion

Sharp recanalization has a high technical success and low rate of adverse events in the recanalization of chronic venous occlusions.

Keywords

Chronic venous occlusion Chronic venous occlusive disease Central venous occlusion Sharp recanalization Transseptal needle Venous reconstruction 

Notes

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 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

This study has obtained Institutional Review Board Approval, and the need for informed consent was waived.

Supplementary material

270_2018_2090_MOESM1_ESM.docx (31 kb)
Supplementary material 1 (DOCX 31 kb)

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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

  • Joseph L. McDevitt
    • 1
  • Ravi N. Srinivasa
    • 2
  • Joseph J. Gemmete
    • 3
  • Anthony N. Hage
    • 4
  • Rajiv N. Srinivasa
    • 3
  • Jacob J. Bundy
    • 3
  • Jeffrey Forris Beecham Chick
    • 5
    Email author
  1. 1.Department of Radiology, Division of Vascular and Interventional RadiologyThe University of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of Interventional RadiologyUniversity of California Los AngelesLos AngelesUSA
  3. 3.Department of Radiology, Division of Vascular and Interventional RadiologyUniversity of Michigan Health SystemAnn ArborUSA
  4. 4.Department of SurgeryThomas Jefferson University HospitalPhiladelphiaUSA
  5. 5.Department of Cardiovascular and Interventional RadiologyINOVA Alexandria HospitalAlexandriaUSA

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