PMID- 30293732
OWN - NLM
STAT- MEDLINE
DCOM- 20190409
LR  - 20190409
IS  - 1535-7732 (Electronic)
IS  - 1051-0443 (Linking)
VI  - 29
IP  - 11
DP  - 2018 Nov
TI  - Single-Center Retrospective Review of Radiofrequency Wire Recanalization of 
      Refractory Central Venous Occlusions.
PG  - 1571-1577
LID - S1051-0443(18)31291-0 [pii]
LID - 10.1016/j.jvir.2018.06.017 [doi]
AB  - PURPOSE: To retrospectively review the effectiveness and safety of radiofrequency 
      (RF) wire recanalization of refractory central venous occlusions (CVOs) and 
      compare recurrent and nonrecurrent CVOs in terms of patient and occlusion 
      characteristics. MATERIALS AND METHODS: Twenty CVOs were treated in 18 patients 
      (age 40 y +/- 13; 9 women) with 11 superior vena cava (SVC) or brachiocephalic vein 
      occlusions (ie, supradiaphragmatic) and 9 inferior vena cava or iliac vein 
      occlusions (ie, infradiaphragmatic). Indications included pain, edema, 
      ulceration, and/or dialysis arteriovenous fistula dysfunction peripheral to the 
      CVO(s). All patients had multiple venous thrombotic risk factors, including 
      mechanical venous compression, endothelial injury, and/or coagulopathies. CVO 
      traversal was first attempted with standard and advanced techniques before RF 
      wire recanalization and followed up with computed tomographic venography and 
      clinic visits approximately 1, 3, 6, and 12 months after treatment. RESULTS: 
      Sixteen CVOs (80%) were successfully transversed and associated with symptom 
      relief. One major complication occurred involving SVC perforation into the 
      pericardial space. Primary CVO patency rate was 56% at a median follow-up of 14.1 
      months (interquartile range [IQR], 9.2-20.0 mo). Recurrent CVOs tended to be 
      infradiaphragmatic (71% vs 12% for supradiaphragmatic; P = .02), longer (12.9 cm 
      +/- 10.0 vs 2.3 cm +/- 1.3; P < .01), and associated with implanted venous stents, 
      filters, or cardiac pacer/defibrillator leads (86% vs 22%; P = .01). Median time 
      to restenosis/occlusion was 1.5 months (IQR, 1.1-6.1 mo). CONCLUSIONS: RF wire 
      recanalization is a relatively effective and safe option for refractory CVOs. 
      Patients with longer, infradiaphragmatic CVOs associated with indwelling devices 
      may require closer follow-up for CVO recurrence.
CI  - Copyright (c) 2018 SIR. Published by Elsevier Inc. All rights reserved.
FAU - Keller, Eric J
AU  - Keller EJ
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611. Electronic address: ejkeller607@gmail.com.
FAU - Gupta, Suraj A
AU  - Gupta SA
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611.
FAU - Bondarev, Sergey
AU  - Bondarev S
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611.
FAU - Sato, Kent T
AU  - Sato KT
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611.
FAU - Vogelzang, Robert L
AU  - Vogelzang RL
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611.
FAU - Resnick, Scott A
AU  - Resnick SA
AD  - Division of Interventional Radiology, Northwestern University, 737 N. Michigan 
      Ave., Suite 1600, Chicago, IL 60611.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20181004
PL  - United States
TA  - J Vasc Interv Radiol
JT  - Journal of vascular and interventional radiology : JVIR
JID - 9203369
SB  - IM
MH  - Adult
MH  - Catheter Ablation/adverse effects/*instrumentation
MH  - Chicago
MH  - Computed Tomography Angiography
MH  - Constriction, Pathologic
MH  - Equipment Design
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Phlebography/methods
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Vascular Access Devices
MH  - Vascular Diseases/diagnostic imaging/physiopathology/*surgery
MH  - Vascular Patency
MH  - Veins/diagnostic imaging/physiopathology/*surgery
MH  - Young Adult
EDAT- 2018/10/09 06:00
MHDA- 2019/04/10 06:00
CRDT- 2018/10/09 06:00
PHST- 2017/12/14 00:00 [received]
PHST- 2018/05/29 00:00 [revised]
PHST- 2018/06/25 00:00 [accepted]
PHST- 2018/10/09 06:00 [pubmed]
PHST- 2019/04/10 06:00 [medline]
PHST- 2018/10/09 06:00 [entrez]
AID - S1051-0443(18)31291-0 [pii]
AID - 10.1016/j.jvir.2018.06.017 [doi]
PST - ppublish
SO  - J Vasc Interv Radiol. 2018 Nov;29(11):1571-1577. doi: 10.1016/j.jvir.2018.06.017. 
      Epub 2018 Oct 4.