Radiofrequency wire-assisted recanalization of a chronically occluded common femoral vein after intravenous drug use

Chronic common femoral vein occlusion presents a significant management challenge, particularly when associated with prior intravenous drug use. We report a 52-year-old woman, sober for 10 years, with symptomatic chronic common femoral vein occlusion after two failed recanalization attempts. Successful recanalization was achieved with a Baylis radiofrequency wire (Baylis Medical), followed by balloon venoplasty and placement of a 14-mm Abre venous stent (Medtronic). The patient experienced symptomatic improvement with preserved patency at 3 months. To our knowledge, this report is the first to describe radiofrequency wire-assisted crossing of a chronic common femoral vein occlusion in a patient with a history of intravenous drug use. We also highlight technique considerations unique to the femoral region-multiplanar venography and the use of arterial landmarks to avoid the femoral artery and femoral nerve-to enhance procedural safety.