Salvage of a Blocked Nephrostomy Catheter Using Needle Recanalization -SURE (Sharp Urologic REcanalization) Technique

We present a novel salvage technique for managing a completely occluded percutaneous nephrostomy catheter in a patient with metastatic cervical cancer and bilateral obstructive uropathy. While the left nephrostomy catheter was exchanged uneventfully, the right was entirely blocked, preventing standard guidewire passage. Using the Accustick II Introducer System (Boston Scientific, Spencer, IN, USA), a 21-gauge needle was advanced through the cut percutaneous nephrostomy lumen to traverse the obstruction, penetrating the catheter sidewall and access the renal collecting system. This allowed sequential guidewire and sheath introduction, enabling successful percutaneous nephrostomy replacement through the existing tract. Termed the Sharp Urologic Recanalization technique, this method modernizes traditional sharp recanalization strategies and offers a less invasive alternative when conventional techniques fail.