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Perioperative fistulogram demonstrating (A) introduction of V18 control wire through the second directional tip sheath placed from the arteriovenous fistula (AVF) and buried into the occlusion brachiocephalic vein immediately adjacent to the tip of the sheath from the femoral access, and (B) insertion of stiff end of the wire via 5F catheter through the sheath in the fistula to accomplish sharp recanalization by perforating through the occlusion into the open snare in the superior vena cava sheath.

Journal: Journal of Vascular Surgery Cases, Innovations and Techniques

Article Title: Multimodality therapy for management of acute on chronic central vein occlusion to maintain patency of upper arm arteriovenous fistula

doi: 10.1016/j.jvscit.2025.101826

Figure Lengend Snippet: Perioperative fistulogram demonstrating (A) introduction of V18 control wire through the second directional tip sheath placed from the arteriovenous fistula (AVF) and buried into the occlusion brachiocephalic vein immediately adjacent to the tip of the sheath from the femoral access, and (B) insertion of stiff end of the wire via 5F catheter through the sheath in the fistula to accomplish sharp recanalization by perforating through the occlusion into the open snare in the superior vena cava sheath.

Article Snippet: A V18 Control wire (Boston Scientific Corporation, Marlborough, MA) was introduced through a second directional tip sheath placed from the AVF and buried into the occluded BCV immediately adjacent to the tip of the sheath from the femoral access ( , A ).

Techniques: Control