Transjugular liver access cannula as a guiding instrument for the recanalization of chronic venous occlusions.

Overview

BACKGROUND: Chronic venous occlusions can result in debilitating symptoms and can be refractory to standard methods of venous recanalization because of the formation of dense fibrous tissue. A transjugular liver access cannula can be incorporated into recanalization efforts to treat such refractory cases. This report describes our experience using the transjugular liver access cannula technique in nine patients. METHODS: A review of patients requiring venous recanalization between May 2012 and October 2014 identified nine cases that required the use of a transjugular liver access cannula as a guiding instrument. Lesion characteristics, technical success, and clinical outcomes were evaluated. RESULTS: The transjugular liver access cannula was used to traverse a total of nine chronic occlusions in both the upper and lower central venous systems in nine patients. The technical success rate was 100%. There were no clinically significant complications. One patient was lost to follow-up. Of the remaining eight patients, seven experienced symptomatic relief within 1 month of recanalization. CONCLUSIONS: The transjugular liver access cannula may serve as a useful adjunctive tool during difficult venous recanalizations, especially when traditional guidewire and catheter techniques fail.