Iliofemoral Venous Occlusion Due to Previous Intravenous Drug Abuse Crossed by Sharp Recanalization Technique With Endovascular Stenting: A Case Report

Recanalization of chronic venous occlusions is sometimes technically challenging. We present a rare case of venous occlusion, due to previous intravenous femoral drug use, with a fibrotic perivenous tissue in the groin, hard to cross. This patient presented with severe venous claudication with an active ulcer. After failure of conventional attempts, we opted for a more aggressive strategy using a modified Chiba needle (Cook Medical)-assisted sharp recanalization technique. We achieved initial technical success in recanalization, but thrombosis eventually recurred because of residual compression on the created extravascular tract. However, the patient showed clinical improvement, and we chose not to attempt another procedure. This case report emphasizes the use of this unconventional crossing technique and provides a detailed, didactic description of the equipment and procedural steps, aiming to illustrate its potential role and limitations in complex venous recanalization.