A catheter system and a radiopaque target 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 with a catheter system and by placing a radiopaque target on the surface of the patient to mark the desired exit point, the catheter system and radiopaque target comprising: (a) the radiopaque target with a central aperture configured to be applied to the surface of the patient to define the desired exit point on the surface of the patient; and (b) the catheter system, wherein the catheter system comprises: an elongate working catheter having a proximal end and a distal end, said working catheter having a closed end blunt dissection distal tip; said closed end blunt dissection distal tip comprising a side aperture and a radiopaque feature comprising a slot formed within the body of said closed end blunt dissection distal tip; a user-manipulated handle coupled to said proximal end of said working catheter; said working catheter having sufficient stiffness push-ability and torque-ability to permit said blunt dissection tip to enter into an occlusion via forces supplied by a user applied to said handle; whereby the rotation of said handle by a user rotates said closed end blunt dissection tip such that the opacity of the slot varies as the closed end blunt dissection tip is rotated; a departure angle guide tube, said departure angle guide tube having a shape memory section formed as a curve and adapted to emerge from said side aperture; 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 for passing through said handle; said needle wire having a sharp dissection tip. (a) the radiopaque target with a central aperture configured to be applied to the surface of the patient to define the desired exit point on the surface of the patient; and (b) the catheter system, wherein the catheter system comprises: an elongate working catheter having a proximal end and a distal end, said working catheter having a closed end blunt dissection distal tip; said closed end blunt dissection distal tip comprising a side aperture and a radiopaque feature comprising a slot formed within the body of said closed end blunt dissection distal tip; a user-manipulated handle coupled to said proximal end of said working catheter; said working catheter having sufficient stiffness push-ability and torque-ability to permit said blunt dissection tip to enter into an occlusion via forces supplied by a user applied to said handle; whereby the rotation of said handle by a user rotates said closed end blunt dissection tip such that the opacity of the slot varies as the closed end blunt dissection tip is rotated; a departure angle guide tube, said departure angle guide tube having a shape memory section formed as a curve and adapted to emerge from said side aperture; 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 for passing through said handle; said needle wire having a sharp dissection tip. an elongate working catheter having a proximal end and a distal end, said working catheter having a closed end blunt dissection distal tip; said closed end blunt dissection distal tip comprising a side aperture and a radiopaque feature comprising a slot formed within the body of said closed end blunt dissection distal tip; a user-manipulated handle coupled to said proximal end of said working catheter; said working catheter having sufficient stiffness push-ability and torque-ability to permit said blunt dissection tip to enter into an occlusion via forces supplied by a user applied to said handle; whereby the rotation of said handle by a user rotates said closed end blunt dissection tip such that the opacity of the slot varies as the closed end blunt dissection tip is rotated; a departure angle guide tube, said departure angle guide tube having a shape memory section formed as a curve and adapted to emerge from said side aperture; 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 for passing through said handle; said needle wire having a sharp dissection tip.