Surfacer Inside-Out Central Venous Catheterization Through an Occluded Inferior Vena Cava

This case describes the use of the Surfacer® Inside-Out Access Catheter System (SIO) from Merit Medical in an occluded inferior vena cava. The procedure typically utilizes right femoral vein access with contraindications of acute iliocaval thrombosis due to possible embolization. After history and imaging studies, the occlusion was determined to be chronic in this case, and a decision was made to employ the SIO procedure using an indwelling catheter. This case demonstrates the use of the SIO procedure in certain settings in patients with central venous occlusions who have exhausted all other options.