Successful Recanalization of a Longstanding Complete Left Subclavian Vein Occlusion by Radiofrequency Perforation with Use of a Radiofrequency Guide Wire

Treatment with radiofrequency (RF) energy can be used to ablate or perforate tissues. The latter involves lower power, higher voltage, and much shorter treatment time, and it is thought to induce much less collateral tissue damage. To date, RF perforation has been successfully used for various cardiac interventions; however, to our knowledge, there has not been a report of its use for peripheral vascular disease. This report describes the successful recanalization of a longstanding occlusion of a left subclavian vein in a 73-year-old woman with polycystic kidney disease and end-stage renal disease undergoing chronic hemodialysis treatment via an upper-extremity arteriovenous fistula. Multiple previous attempts at mechanical recanalization were unsuccessful. Recanalization was achieved by RF perforation with use of a PowerWire RF guide wire.