Central vein occlusion (CVO) in a patient with kidney failure can be very challenging, often limiting access to hemodialysis (HD). The conventional endovascular treatments for CVO, such as angioplasty and stenting, depend on successfully negotiating a guidewire across the occluded segment. Failure to cross the occluded segment creates a clinical challenge and warrants techniques and interventions that are inherently fraught with serious complications. The currently available options to navigate the occluded segment include either an open surgical or advanced endovascular procedure.