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

PurposeTo report the technical success and complications following sharp recanalization of chronic venous occlusions.Materials and MethodsA total of 123 patients, including 75 (61.0%) men and 48 (39.0%) women, with mean age of 50.517.5years (range 19-90years), 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 3.21.4cm (range 1.3-10.9cm).Results p id=Par3 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.