Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter

A 78-year-old man with end-stage renal disease and a right brachial-cephalic upper arm direct hemodialysis access presented with symptomatic central venous occlusion. The right brachiocephalic vein occlusion in this patient was refractory to wire traversal. Sharp recanalization of the central venous occlusion was done with an Outback LTD re-entry catheter (Cordis Corporation, a Johnson & Johnson Company, Miami, Fla). The track was balloon dilated and stented. When the conventional management options fail, this technique may be used to salvage a precious dialysis access and to relieve the patient from symptoms of central venous hypertension.