This video explores innovative technologies for central line management, focusing on solutions for blocked superior vena cava (SVC). Dr. Nathan Fagan discusses the MeritMedical Surfacer system for image-guided SVC recanalization via a femoral approach. The presentation also delves into the potential of 4D intracardiac echo catheters for radiation-free recanalization and reviews transhepatic and translumbar access as last-resort options when traditional venous access is lost.