Needle recanalization of occluded superior mesenteric vein via a covered stent in a patient with TIPS extending into splenic vein.

Asian J Surg

Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:

Published: September 2024

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http://dx.doi.org/10.1016/j.asjsur.2024.09.097DOI Listing

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Needle recanalization of occluded superior mesenteric vein via a covered stent in a patient with TIPS extending into splenic vein.

Asian J Surg

September 2024

Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:

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Background: Many cases of chronic thoracic central vein occlusion (CVO) fail to recanalize using the standard conventional guidewire technique. This study aims to present the outcomes of sharp recanalization with a transseptal needle in chronic thoracic CVO.

Methods: This retrospective study involved 22 hemodialysis patients who developed clinical signs and symptoms of CVO, had unsuccessful conventional endovascular treatment using guidewire, and underwent sharp recanalization with a transseptal needle from January 2018 to December 2021.

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Purpose: To describe a novel bailout technique to approach below-the-ankle (BTA) chronic total occlusions or plantar-arch severe disease where the balloon/catheter is unable to follow the crossing guidewire and no other described recanalization approach is feasible.

Technique: When facing a complex BTA revascularization, if the guidewire crosses but the balloon cannot progress due to a lack of pushability, an antegrade puncture of the infrapopliteal vessel where the tip of the guidewire lays is performed. The guidewire is then carefully navigated through this distal BTA vessel into the needle to achieve its rendezvous and externalization.

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Review of Sharp Recanalization Techniques in Central Venous Occlusions.

Cardiovasc Intervent Radiol

December 2024

Division of Vascular and Interventional Radiology, Medical University of South Carolina, Charleston, SC, USA.

Benign central venous occlusions are frequently associated with long-term central venous access. Most of these occlusions can be recanalized with conventional endovascular technique. When conventional technique fails, sharp recanalization techniques (SRTs) can increase technical success.

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