Document Detail

Use of a rosch-uchida needle for recanalization of refractory dialysis-related central vein occlusion.
MedLine Citation:
PMID:  20410425     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to evaluate our experience with the use of a R?sch-Uchida needle technique to recanalize central vein occlusion that cannot be traversed with a guidewire. MATERIALS AND METHODS: We retrospectively evaluated 33 recanalization procedures performed with a R?sch-Uchida needle on 20 men and 13 women with central vein occlusion during the period January 1999-December 2008. The occlusions were in the subclavian vein (n = 29) and the brachiocephalic vein (n = 4). A 9- or 10-French R?sch-Uchida introducer sheath was advanced centrally to abut the occlusion. The R?sch-Uchida needle was directed and advanced toward a transfemoral angiographic catheter placed on the central side of the occlusion. After passage of a guidewire through the occlusion, balloon angioplasty and stent insertion were performed. The outcome measures evaluated were technical success rate, primary and secondary patency, and complication rate. RESULTS: The mean occlusion length was 1.73 +/- 0.8 cm. The rate of technical success of recanalization was 93.9% (31 of 33 procedures). The 3-, 6-, and 12-month primary patency rates were 43.6%, 24%, and 8%, and the 3-, 6-, and 12-month secondary patency rates were 77.4%, 68.8% and 55.9%. One patient reported shoulder pain lasting 2 weeks, which resolved with conservative treatment. CONCLUSION: Use of a R?sch-Uchida needle to recanalize central vein occlusion refractory to a traditional procedure is feasible and safe and can preserve the involved extremity for long-term hemodialysis.
Dong Erk Goo; Yong Jae Kim; Deuk Lin Choi; Sung Il Park; Seung Boo Yang; Cheol Moon; Dan Song
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  194     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1352-6     Citation Subset:  AIM; IM    
Department of Radiology, Soonchunhyang University Hospital, 22 Daesagwan-gil, Yongsan-gu Seoul, 140-210, Republic of Korea.
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MeSH Terms
Catheterization, Peripheral / instrumentation*,  methods
Middle Aged
Renal Dialysis / adverse effects*
Reperfusion / instrumentation*,  methods
Treatment Outcome
Venous Thrombosis / etiology*,  radiography,  therapy*

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