Advertisement

CardioVascular and Interventional Radiology

, Volume 40, Issue 11, pp 1777–1783 | Cite as

Fluoroscopic Targeting of Wallstents and Amplatzer Vascular Plugs in Sharp Recanalization of Chronic Venous Occlusions

  • Minhaj S. Khaja
  • Jeffrey Forris Beecham Chick
  • Ari D. Schuman
  • Kyle J. Cooper
  • Bill S. Majdalany
  • Wael E. Saad
  • David M. Williams
Technical Note

Abstract

Introduction/Purpose

Sharp recanalization of chronic venous occlusions is usually performed with targeting of wire-capture devices like loop snares or balloons. We describe sharp recanalization of chronic venous occlusions using self-expanding stents and vascular plugs.

Material and Methods

We retrospectively reviewed all sharp venous recanalization procedures performed over an 11-month period and found Wallstent and Amplatzer vascular plug (AVP) targeting was performed in 16 patients. Patient demographics, occlusion site, targeting device, technical success of the targeting, and overall procedural success were recorded.

Results

Technical success was achieved in twelve (86%) Wallstent and two (67%) AVP deployments. Procedural success was achieved in 15 (94%). Three minor complications occurred.

Conclusion

Wallstent and AVP targeting may be a useful technique when performing sharp recanalization for chronic venous occlusions. These devices expand the target space and present the same cross section viewed from any angle and can directly capture and extract the wire, features helpful in regions with crowded vascular anatomy.

Keywords

Sharp recanalization Targeting Chronic venous occlusion 

Abbreviations

AVP

Amplatzer vascular plug

IVC

Inferior vena cava

SVC

Superior vena cava

Notes

Acknowledgement

The authors would like to acknowledge Dr. Ben Shin for his illustration noted as Fig. 1.

Compliance with Ethical Standards

Conflict of interest

Minhaj S. Khaja, Jeffrey Forris Beecham Chick, Ari D. Schuman, Kyle J. Cooper, Bill S. Majdalany, and Wael E. Saad have no conflicts of interest. David M. Williams is on the Scientific Advisory Board of Boston Scientific Corporation and is a consultant for W. L. Gore and Associates.

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

For retrospective studies at our institution, formal consent is not required.

References

  1. 1.
    Porter D, Rundback JH, Miller S. Sharp recanalization using a subintimal reentry device, angioplasty, and stent placement for severely symptomatic iliofemoral deep venous thrombosis secondary to congenital aplasia of the inferior vena cava. J Vasc Interv Radiol. 2010;21(11):1765–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Amin P, Sharafuddin MJ, Laurich C, Nicholson RM, Sun RC, Roh S, Kresowik TF, Sharp WJ. Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique. Ann Vasc Surg. 2012;26(2):276.e5–9.CrossRefGoogle Scholar
  3. 3.
    Anil G, Taneja M. Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter. J Vasc Surg. 2010;52(4):1038–40.CrossRefPubMedGoogle Scholar
  4. 4.
    Arabi M, Ahmed I, Mat’hami A, Ahmed D, Aslam N. Sharp central venous recanalization in hemodialysis patients: a single-institution experience. Cardiovasc Intervent Radiol. 2016;39(6):927–34.CrossRefPubMedGoogle Scholar
  5. 5.
    Athreya S, Scott P, Annamalai G, Edwards R, Moss J, Robertson I. Sharp recanalization of central venous occlusions: a useful technique for haemodialysis line insertion. Br J Radiol. 2009;82(974):105–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Beathard GA, Eradat J. Chronically occluded arteriovenous fistula salvaged by sharp needle recanalization. Semin Dial. 2015;28(6):E58–63.CrossRefPubMedGoogle Scholar
  7. 7.
    Mindikoglu AL, Miller JS, Borge MA, Van Thiel DH. Post-transplant IVC occlusion and thrombosis treated with tPA, heparin, and sharp recanalization. J Gastroenterol. 2005;40(3):302–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Farrell T, Lang EV, Barnhart W. Sharp recanalization of central venous occlusions. J Vasc Interv Radiol. 1999;10(2 Pt 1):149–54.CrossRefPubMedGoogle Scholar
  9. 9.
    Honnef D, Wingen M, Günther RW, Haage P. Sharp central venous recanalization by means of a TIPS needle. Cardiovasc Intervent Radiol. 2005;28(5):673–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Ito N, Isfort P, Penzkofer T, Grommes J, Greiner A, Mahnken A. Sharp recanalization for chronic left iliac vein occlusion. Cardiovasc Intervent Radiol. 2012;35(4):938–41.CrossRefPubMedGoogle Scholar
  11. 11.
    Malik AK, Bhalla N, Goel A, Prakash S. Percutaneous reconstruction of chronic total occlusion of brachiocephalic vein using transseptal needle in dialysis-dependent patient. Cardiovasc Interv Ther. 2016;31(2):136–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Williams DM. Iliocaval reconstruction in chronic deep vein thrombosis. Tech Vasc Interv Radiol. 2014;17(2):109–13.CrossRefPubMedGoogle Scholar
  13. 13.
    Arabi M, Krishnamurthy V, Cwikiel W, Vellody R, Wakefield TW, Rectenwald J, Williams D. Endovascular treatment of thrombosed inferior vena cava filters: techniques and short-term outcomes. Indian J Radiol Imaging. 2015;25(3):233–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Omary RA, Bettmann MA, Cardella JF, Bakal CW, Schwartzberg MS, Sacks D, et al. Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol JVIR. 2002;13(9 Pt 1):879–81.CrossRefPubMedGoogle Scholar
  15. 15.
    Majdalany BS, Elliott ED, Michaels AJ, Hanje AJ, Saad WE. Radiofrequency wire recanalization of chronically thrombosed TIPS. Cardiovasc Intervent Radiol. 2016;39(7):1040–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Minhaj S. Khaja
    • 1
  • Jeffrey Forris Beecham Chick
    • 1
  • Ari D. Schuman
    • 1
  • Kyle J. Cooper
    • 1
  • Bill S. Majdalany
    • 1
  • Wael E. Saad
    • 1
  • David M. Williams
    • 1
  1. 1.Division of Vascular and Interventional Radiology, Department of RadiologyUniversity of Michigan Health SystemAnn ArborUSA

Personalised recommendations