Direct Translumbar Inferior Vena Cava Ports for Long-Term Central Venous Access in Patients with Cancer

Occlusion of traditional sites for central venous cannulation is a challenging problem in patients that require a permanent central venous line for chronic administration of nutrients or drugs. In rare cases, extensive central venous thrombosis of the superior and inferior vena cava may preclude catheterization, and uncommon routes should be used. We describe our approach for placement of chronic central venous lines in two pediatric patients with short bowel syndrome and extensive caval occlusion.

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Long-Term Infusion in Cancer Chemotherapy with the Groshong Catheter via the Inferior Vena Cava

Tumori Journal ◽

10.1177/030089169608200415 ◽

1996 ◽

Vol 82 (4) ◽

pp. 372-375 ◽

Cited By ~ 2

Author(s):

Luca Tavecchio ◽

Amedeo V. Bedini ◽

Rodolfo Lanocita ◽

GianLuigi Patelli ◽

Ilaria Donati ◽

...

Keyword(s):

Inferior Vena Cava ◽

Superior Vena Cava ◽

Cancer Chemotherapy ◽

Vascular Access ◽

Inferior Vena ◽

Superior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Rest Period

Aims and background Vascular access through a vein draining into the superior vena cava is commonly used for long-term infusion of drugs inr cancer chemotherapy; prolonged cannulation of the inferior vena cava is generally considered as having an excessively high complication rate. Methods Prolonged cisplatin infusion via the inferior vena cava by means of a Groshong catheter was evaluated in 20 consecutive patients with thoracic malignancies showing evidence of superior vena cava infiltration or obstruction. Results We achieved 1,291 catheter days for our survey with a mean duration of vascular access of 64.5 days per patient and a mean duration of infusion time of 40 days. There were 2 complications, a catheter obstruction after a 7-day rest period and an ileo-femoral thrombosis 6 days after catheter placement. Conclusions Our experience compared favourably with the results obtained by long-term central venous access via the supraumbilical route, and demonstrated the reliability and safety of this approach in cases where the superior vena cava cannulation is technically difficult or impossible.

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Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access

10.1093/med/9780199986071.003.0044 ◽

2018 ◽

Author(s):

Mikin V. Patel ◽

Steven Zangan

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Catheter ◽

Catheter Placement ◽

Direct Access ◽

Hepatic Veins ◽

Central Venous ◽

Direct Puncture

In patients requiring long-term chemotherapy, antibiotics, hemodialysis, or parenteral nutrition, central venous access is usually possible via catheter placement in the jugular, subclavian, or femoral veins. As these routes become complicated by thrombosis, stenosis, infection, or surgical intervention, the options for central venous catheter placement become limited, and direct puncture of the inferior vena cava (IVC) may be required. This chapter reviews the technique for placement of a catheter in the IVC via translumbar approach. Because direct access using anatomic landmarks can be challenging, initial puncture of the hepatic veins can be used to guide placement of an IVC catheter.

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