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A 75-year-old woman with hemodialysis-related right subclavian vein occlusion was referred to our hospital for retry of endovascular treatment. The occluded segment could not be crossed via either antegrade or retrograde approaches, including puncturing the obstruction with the stiff end of the guide wire. The obstruction was successfully punctured using a 75-cm long 21-G needle via the right median...
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