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Cardiovasc Intervent Radiol. 2019 Feb;42(2):205-212. doi: 10.1007/s00270-018-2090-1. Epub 2018 Nov 20.

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

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Department of Radiology, Division of Vascular and Interventional Radiology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
Department of Interventional Radiology, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
Department of Surgery, Thomas Jefferson University Hospital, 1100 Walnut Street, Philadelphia, PA, 19107, USA.
Department of Cardiovascular and Interventional Radiology, INOVA Alexandria Hospital, 4320 Seminary Road, Alexandria, VA, 22304, USA.



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


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).


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.


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


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

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