Fig. 3

a 8 y/o M with history of left lower extremity DVT 1 month after ECMO cannulation for respiratory and cardiac failure. The left femoral vein was used for venous access for ECMO cannula. Venogram demonstrates short segment occlusion of the left external iliac with patent left common femoral, common iliac vein, and IVC. b A 0.035″ stiff hydrophilic wire was passed across the occlusion and through the native vessel lumen. c Balloon angioplasty was performed with noncompliant balloon; no appreciable waist present with balloon inflation. d Final venogram demonstrates a patent channel with persistent collateral vessels and no extravasation or vessel injury