Invasive Recanalization and Rehabilitation of Chronically Occluded Central Veins: Changing the Treatment Paradigm for Pediatric Patients with Long-term Access Needs or Venous Congestion

Background: Thrombotic central venous occlusions limit access and increase morbidity in chronically ill and hospitalized pediatric patients and those with thrombophilia. However, anticoagulation therapy has limited efficacy in reestablishing vein patency. In patients with chronic or recurrent central access needs, venous occlusions typically result in abandonment of each site for a different vein until access options become scarce. We report results of invasive trans-catheter recanalization of completely occluded central veins using angioplasty and stent implantation. Methods: All patients undergoing intervention on occluded central veins at our institution from 4/2013-11/2015 were included. Clinical, procedural, and follow-up data were retrospectively reviewed. Results: Forty-five completely occluded …