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

Journal Article · Fri Feb 15 04:00:00 EST 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-018-2090-1· OSTI ID:22953158

McDevitt, Joseph L. ^[1]; Srinivasa, Ravi N. ^[2]; Gemmete, Joseph J. ^[3]; Hage, Anthony N. ^[4]; Srinivasa, Rajiv N.; Bundy, Jacob J. ^[3]

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1. The University of Texas Southwestern Medical Center, Department of Radiology, Division of Vascular and Interventional Radiology (United States)
2. University of California Los Angeles, Department of Interventional Radiology (United States)
3. University of Michigan Health System, Department of Radiology, Division of Vascular and Interventional Radiology (United States)
4. Thomas Jefferson University Hospital, Department of Surgery (United States)

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.

• OSTI ID: 22953158
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANESTHESIA
CARDIAC PACEMAKERS
COMPUTERIZED TOMOGRAPHY
FLUOROSCOPY
LUNGS
MULTIVARIATE ANALYSIS
NEOPLASMS
SURGERY
THROMBOSIS
ULTRASONOGRAPHY
VEINS