Occlusion access systems

A catheter system for use by a user for gaining access to the central venous system of a patient through an occlusion in a large vessel in the upper chest region of said patient, the catheter system comprising:

• a radiopaque target having a radiopaque area and a radiolucent area configured to be applied to the exterior of said patient and define an exit point;
• an elongate working catheter having a proximal end and a distal end including a side aperture;
• a handle coupled to said proximal end of said elongate working catheter;
• a departure angle guide tube configured to be disposed distally within the elongate working catheter and adapted to emerge from the side aperture thereby defining a needle wire exit plane;
• a needle wire contained and located within said departure angle guide tube and adapted for relative motion with respect to said departure angle guide tube and extension through the departure angle guide tube at a departure angle in the departure angle plane, said needle wire having a sharp dissection tip configured to be forced through the occlusion, the vessel wall intervening tissue and skin to exteriorize at the surface of the patient at said exit point.