The Inside-out Technique Is Safe and Effective in Thoracic Central Venous Obstruction

Abstract

Thoracic central venous obstruction (TCVO) presents a challenging scenario for patients requiring central venous access. The inside-out technique for crossing occluded veins has been described to avoid femoral catheters and to preserve the left-sided thoracic venous vasculature, but case series are limited by number of patients. The purpose of this study was to evaluate the use of the inside-out technique at a single tertiary academic center together with its efficacy and outcome, paying close attention to the severity of TCVO using the Society of Interventional Radiology (SIR) TCVO classification (Figure).