8:00 AM Abstract No. 20 - Radiofrequency wire recanalization of chronic central venous occlusions is effective but not without the potential for complications

Abstract

Evaluate the safety and efficacy of radiofrequency wire (RF wire) recanalization of chronic central venous occlusion after failure using conventional techniques. Retrospective analysis of 13 consecutive venous recanalization procedures from 1/2007 to 12/2012 using a RF wire was performed. After the presence of central vein occlusion was confirmed with venography, antegrade passage of the occlusion was attempted with various angiographic catheters and hydrophilic guidewires. If these methods failed, a radiofrequency wire was used. Technical success rate and complication rates were evaluated. Technical success was achieved in 9/13 occluded vessels in 9/12 patients. Two patients (16.7%) experienced minor complications and 1 patient (8.3%) experienced a major complication. The minor complications were contrast extravasations demonstrated on angiography not requiring further treatment. The major complication was tracheal perforation requiring bronchoscopy and advanced care. Use of a radiofrequency wire to recanalize central vein occlusion refractory to a traditional procedure is a viable option in patients without other potential access sites. Currently available data suggests that the device is 100% efficacious without reported major complications. In our experience, the technique was less than perfect with a technical success of 69% and potential for major complications (8.3%).