title: Recanalization of chronic refractory central venous occlusions utilizing a radiofrequency guidewire perforation technique.
abstract: OBJECTIVE
  To assess the technical success rate and safety of radiofrequency perforation guidewire (RF) technology for the recanalization of refractory chronic central venous occlusions in symptomatic hemodialysis patients with failed conventional endovascular methods.
  
  
  METHODS
  This single center retrospective cohort of hemodialysis patients comprised of six men (mean age 67 years, range 55 to 80) with autogenous fistulae, who had already undergone failed conventional endovascular methods. These patients underwent the RF perforation technique from December 2006 to January 2010.
  
  
  RESULTS
  Three patients were successfully treated using the RF perforation technique, after which they had PTFE stent grafts placed at the site of occlusion. There was no recurrence of clinical symptoms. In the remaining three patients, the procedure was terminated after multiple unsuccessful attempts. There were no complications.
  
  
  CONCLUSIONS
  The RF perforation technique is a potential alternative technology for recanalization of refractory chronic central venous occlusions in hemodialysis patients in the setting of failed conventional endovascular recanalization techniques.
authors.affiliation: Department of Diagnostic Imaging, Scarborough Hospital-General Division, Toronto, Canada. sanjoy_kundu40@hotmail.com
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Kundu
authors.forename: Milad
authors.initials: M
authors.lastname: Modabber
authors.forename: John M
authors.initials: JM
authors.lastname: You
authors.forename: Paul
authors.initials: P
authors.lastname: Tam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D003251:Constriction, Pathologic; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011677:Punctures; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D062666:Vascular Access Devices; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000601:surgery