{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:09:17Z","timestamp":1788815357605,"version":"build-2803163510"},"reference-count":4,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Chronic superior vena cava (SVC) occlusion is a challenging complication in hemodialysis patients, particularly when conventional endovascular approaches fail. We describe the successful use of a manually straightened transseptal needle for sharp recanalization in a symptomatic dialysis patient with extensive collateralization and exhausted access options. Prior attempts using re-entry devices and back-ends of stiff guidewires had been unsuccessful. Under biplanar fluoroscopy, the transseptal needle was advanced transfemorally to cross the occlusion, allowing passage of a 0.018\u2033 guidewire and subsequent snaring through a left axillary loop graft. A VBX 11\u2009\u00d7\u200939\u2009mm balloon-expandable stent-graft was deployed and post-dilated to 14\u2009mm. Clinical symptoms, including facial and upper limb edema with prominent thoracic collateral veins, resolved by the following morning. No complications occurred, and patency remains stable at 9\u2009months. This case highlights the utility of transseptal needles as a readily available sharp recanalization tool in expert centers, especially when other strategies have failed.<\/jats:p>","DOI":"10.1177\/11297298261437527","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T11:54:12Z","timestamp":1775303652000},"page":"2397-2401","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Recanalization of chronic superior vena cava occlusion using a transseptal needle in a dialysis patient"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-018X","authenticated-orcid":false,"given":"Lu\u00eds","family":"Loureiro","sequence":"first","affiliation":[{"name":"Angiology and Vascular Surgery Department, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto (ICBAS-UP), Porto, Portugal"},{"name":"Grupo de Estudos Vasculares, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6316-7751","authenticated-orcid":false,"given":"Paulo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Angiology and Vascular Surgery Department, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Grupo de Estudos Vasculares, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2689-6012","authenticated-orcid":false,"given":"Davide","family":"Freitas","sequence":"additional","affiliation":[{"name":"Radiology Department, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Machado","sequence":"additional","affiliation":[{"name":"Angiology and Vascular Surgery Department, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto (ICBAS-UP), Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.08.038"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100970"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2021.08.007"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2018.06.017"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261437527","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261437527","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261437527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:47:18Z","timestamp":1788814038000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261437527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,4]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/11297298261437527"],"URL":"https:\/\/doi.org\/10.1177\/11297298261437527","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,4]]}}}