Chronic central venous occlusion presents a difficult management problem, particularly when the occlusion cannot be traversed with a guide wire, a step which is essential for endovascular treatment such as balloon angioplasty and stent placement. We describe a less invasive technique in which the venous occlusion is traversed with a Rosch-Uchida Transjugular Liver Access Set. This procedure may be useful in cases where the involved extremity must be preserved for hemodialysis and where subclavian vein occlusion is refractory to traditional revascularization methods.