Radiofrequency thermal wire is a useful adjunct to treat chronic central venous occlusions

Conventional techniques for central venous recanalization are successful in crossing most lesions but still fail in many patients. We used a radiofrequency wire in these failed cases. We report three patients with complicated central venous occlusions in whom conventional catheter and guidewire techniques were not successful and who were successfully treated using the PowerWire Radiofrequency Guidewire (Baylis Medical Company Inc, Montreal, QC, Canada). Occlusions were traversed using the radiofrequency wire, followed by angioplasty and stenting. The average length recanalized was 8.2 ± 3.6 cm. One patient required repeat angioplasty at 4 months. All stents were patent at 12 to 15 months. The radiofrequency wire is valuable in the management of patients with refractory central venous occlusions.