Safety and efficacy of radiofrequency wire recanalization of chronic central venous occlusions.
J Vasc Access. 2015 Feb 4;0(0):0
Authors: Sivananthan G, MacArthur DH, Daly KP, Allen DW, Hakham S, Halin NJ
PURPOSE: The purpose of this study is to evaluate the safety and efficacy of using a radiofrequency wire (RF) for central venous occlusion (CVO) recanalization after failure using conventional techniques.
MATERIALS AND METHODS: A retrospective analysis of all central venous recanalization procedures using an RF wire from January 2007 to December 2012 was performed. This comprised 13 consecutive procedures in 12 patients. The electronic medical record and radiologic imaging studies were reviewed to obtain information regarding patient demographics, indication for revascularization, duration of vascular occlusion, procedure outcome, and complications.
RESULTS: Technical success was achieved in nine of 13 (69%) occluded vessels in nine of 12 (75%) patients. Lengths of successfully crossed lesions (mean 29.8 ± 29.3 mm) were significantly less than those of unsuccessfully crossed lesions (mean 90 ± 73.7 mm), p = 0.039. Of the nine patients with technically successful procedures, three died with patent stents of causes unrelated to the procedure, one had a patent stent at 547 days, two had stent patency of 94 days and 345 days, and three were lost to follow-up. One patient (8.3%) experienced a major complication wherein tracheal perforation by the RF wire contributed to the patient's death.
CONCLUSIONS: RF recanalization is a viable option in patients with central vein occlusion refractory to traditional procedures. However, it does not guarantee successful revascularization and is not without the potential for harm.
PMID: 25656250 [PubMed - as supplied by publisher]