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Evaluating a Novel Telescoping Catheter Set for Treatment of Central Venous Occlusions

Travis J Vowels1, Tony Lu2, M Mujeeb Zubair1

  • 1Division of Vascular and Endovascular Surgery, Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX.

Annals of Vascular Surgery
|September 5, 2020
PubMed

Insights

The TriForce catheter significantly improved central venous occlusion recanalization rates in end-stage renal disease patients. This novel device offers a better solution for complex venous occlusions compared to traditional methods.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Central venous occlusive disease (CVOD) is a common complication in end-stage renal disease (ESRD) patients, often leading to dialysis access issues.
  • Existing treatments for CVOD can be challenging, necessitating advanced endovascular techniques.
  • The TriForce® Peripheral Crossing Set is a novel, reinforced, telescoping catheter designed to aid in crossing difficult central venous occlusions.

Purpose of the Study:

  • To evaluate the efficacy of the TriForce® Peripheral Crossing Set for endovascular recanalization of central venous occlusions.
  • To compare the technical success rates and outcomes of using the TriForce set versus traditional wire/catheter sets.

Main Methods:

  • A single-center retrospective study involving 37 patients and 56 recanalization attempts over 17 months.
  • Patients were divided into two groups: those treated with traditional wire/catheter sets (40 attempts) and those treated with the TriForce catheter set (16 attempts).
  • Technical success rates, procedural data, and patient outcomes were compared between the two groups.

Main Results:

  • The TriForce catheter set demonstrated a significantly higher technical success rate (69%) compared to traditional sets (38%) (P=0.04).
  • Four patients were successfully recanalized with the TriForce set after prior failure with traditional methods.
  • While fluoroscopy time and radiation dose were higher with the TriForce set, 1-year freedom from reintervention was comparable (60% vs. 44%).

Conclusions:

  • The TriForce reinforced telescoping catheter set is an effective adjunct for improving recanalization rates in central venous occlusive disease.
  • This novel device shows promise in managing complex venous occlusions, particularly in patients with ESRD.
  • Further prospective studies may be warranted to confirm these findings and optimize its use.
Abstract

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