USE OF A PUNCTURE NEEDLE FOR RECANALIZATION OF AN OCCLUDED RIGHT SUBCLAVIAN VEIN

We report a patient in whom we used a puncture needle to initiate perc utaneous recanalization of a chronic occlusion of the junction between the right subclavian vein and the right brachiocephalic vein. Under f luoroscopic guidance, an 18-gauge needle was used to puncture the righ t subclavian vein. When contrast material injected through the needle confirmed intravascular location, the needle was advanced until it def lected and perforated an occlusion balloon target positioned within th e right brachiocephalic vein. This technique may be useful in patients with central venous occlusions that are refractory to traversal using traditional catheter and guidewire techniques.