Modified Sharp Recanalization for Inferior Vena Cava Occlusion in Patient with Budd-Chiari Syndrome

We report a case of Budd-Chiari syndrome successfully treated with endovascular recanalization of an inferior vena cava occlusion using a modified sharp recanalization technique. A 45-year-old man presented with hepatic dysfunction, and contrast-enhanced computed tomography revealed a 1.5 cm chronic inferior vena cava occlusion. Standard sharp recanalization using the conventional end of a guidewire failed to cross the lesion. Therefore, we reshaped the end of a 0.035-inch guidewire into a sharper form, enabling successful penetration without the use of specialized devices. This modified technique, adapted from peripheral artery interventions, may offer a safer and more cost-effective option for treating fibrotic venous occlusions. Stepwise balloon dilation was subsequently performed to minimize complications. This report highlights the potential utility of a reshaped guidewire end as a practical alternative when the conventional technique fails.