Central Venous Access in Pediatric Patients

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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Inferior vena cava implant of permanent central venous access devices

Journal of Chemotherapy ◽

10.1179/joc.1997.9.2.157 ◽

1997 ◽

Vol 9 (2) ◽

pp. 157-158

Author(s):

F. D'angelo ◽

G. Ramacciato ◽

P. Aurello ◽

S. Broglia ◽

S. Cataldi ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Central Venous ◽

Venous Access Devices

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Translumbar ports: feasibility and efficacy of direct translumbar inferior vena cava approach for long-term central venous access

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2013.01.055 ◽

2013 ◽

Vol 24 (4) ◽

pp. S25

Author(s):

S.R. Butros ◽

R. Oklu ◽

G. Walker ◽

S.P. Kalva ◽

G.M. Salazar ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Central Venous

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Inferior Vena Cava: Translumbar Catheterization for Central Venous Access

Radiology ◽

10.1148/172.3.1013 ◽

1989 ◽

Vol 172 (3) ◽

pp. 1013-1014 ◽

Cited By ~ 36

Author(s):

Donald F. Denny ◽

Lee H. Greenwood ◽

Steven S. Morse ◽

Graham K. Lee ◽

Julio Baquero

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Central Venous

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Management of a small bowel transplant with complicated central venous access in a patient with asymptomatic superior and inferior vena cava obstruction

Transplantation Proceedings ◽

10.1016/j.transproceed.2003.12.005 ◽

2004 ◽

Vol 36 (2) ◽

pp. 388-391 ◽

Cited By ~ 8

Author(s):

T.T Mims ◽

T.M Fishbein ◽

D.E Feierman

Keyword(s):

Small Bowel ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Central Venous ◽

Inferior Vena Cava Obstruction ◽

Small Bowel Transplant

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Ultrasound-guided cannulation of the superficial femoral vein for central venous access

The Journal of Vascular Access ◽

10.1177/11297298211003745 ◽

2021 ◽

pp. 112972982110037

Author(s):

Maria Giuseppina Annetta ◽

Bruno Marche ◽

Laura Dolcetti ◽

Cristina Taraschi ◽

Antonio La Greca ◽

...

Keyword(s):

Inferior Vena ◽

Femoral Vein ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Ultrasound Guided ◽

Central Venous ◽

Superficial Femoral Vein ◽

Ultrasound Guided Puncture ◽

Guided Puncture

Background: In some clinical conditions, central venous access is preferably or necessarily achieved by threading the catheter into the inferior vena cava. This can be obtained not only by puncture of the common femoral vein at the groin, but also—as suggested by few recent studies—by puncture of the superficial femoral vein at mid-thigh. Methods: We have retrospectively reviewed our experience with central catheters inserted by ultrasound-guided puncture and cannulation of the superficial femoral vein, focusing mainly on indications, technique of venipuncture, and incidence of immediate/early complications. Results: From June 2020 to December 2020, we have inserted 98 non-tunneled central venous catheters (tip in inferior vena cava or right atrium) by ultrasound-guided puncture of the superficial femoral vein at mid-thigh or in the lower third of the thigh, all of them secured by subcutaneous anchorage. The success of the maneuver was 100% and immediate/early complications were negligible. Follow-up of hospitalized patients (72.5% of all cases) showed only one episode of catheter dislodgment, no episode of infection and no episode of catheter related thrombosis. Conclusions: The ultrasound approach to the superficial femoral vein is an absolutely safe technique of central venous access. In our experience, it was not associated with any risk of severe insertion-related complications, even in patients with low platelet count or coagulation disorders. Also, the exit site of the catheter at mid-thigh may have advantages if compare to the exit site in the inguinal area.

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Current Management of Difficult Central Venous Access in Pediatric Patients

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.201937 ◽

2019 ◽

Author(s):

Wongsakorn Chaochankit ◽

Surasak Sangkhathat

Keyword(s):

Pediatric Patients ◽

Superior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Surgical Techniques ◽

Venous Access ◽

Current Approach ◽

Central Venous ◽

End Stage

The central venous catheter (CVC) has become an integral part of various long term parenteral therapies including chemotherapy and parenteral nutrition. In pediatric patients with a long term CVC, multiple repeated accesses and catheter-related complications may lead to difficulty in reestablishment of a line. Strategies in CVC management in these patients should begin with choosing an appropriate catheter according to its purpose, choosing the right access site and prompt treatment of potential complications, especially catheter-related thrombosis. In patients with severe restriction of the superior vena cava and its tributaries, end-stage central venous access is diagnosed. Management of this situation requires a multidisciplinary team and alternative routes of venous access including access through small collateral veins, or through an unusual vein such as the hepatic vein or a gonadal vein, and/or use of alternative surgical techniques. This article provides a comprehensive review regarding the current approach and surgical options in pediatric patients with end-stage central venous access.

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

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2013.12.016 ◽

2014 ◽

Vol 25 (4) ◽

pp. 556-560 ◽

Cited By ~ 7

Author(s):

Selim R. Butros ◽

T. Gregory Walker ◽

Gloria M. Salazar ◽

Sanjeeva P. Kalva ◽

Rahmi Oklu ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Central Venous ◽

Patients With Cancer

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Missed guide wire in inferior vena cava after central venous cannulation

Anesthesia Essays and Researches ◽

10.4103/0259-1162.177185 ◽

2017 ◽

Vol 11 (1) ◽

pp. 271

Author(s):

GauravSingh Tomar ◽

Sumit Charan ◽

Neeraj Mishra ◽

Shailendra Kumar

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Guide Wire ◽

Vena Cava ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Central Venous

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How I treat central venous access device–related upper extremity deep vein thrombosis

Blood ◽

10.1182/blood-2016-08-693671 ◽

2017 ◽

Vol 129 (20) ◽

pp. 2727-2736 ◽

Cited By ~ 20

Author(s):

Anita Rajasekhar ◽

Michael B. Streiff

Keyword(s):

Central Venous Access ◽

Vena Cava ◽

Venous Access ◽

Postthrombotic Syndrome ◽

Central Venous ◽

Central Venous Access Device ◽

Access Device ◽

Persistent Symptoms ◽

Vena Cava Filters ◽

Venous Access Device

AbstractCentral venous access device (CVAD)-related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access, and postthrombotic syndrome. Patient-, device-, and treatment-related factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for the prevention of CRT remains to be established. Therefore, minimizing patient exposure to known risk factors is the best available approach to prevent CRT. Venous duplex is recommended for the diagnosis of CRT. Anticoagulation for at least 3 months or the duration of the indwelling CVAD is recommended for treatment of CRT. Thrombolysis should be considered for patients at low risk for bleeding who have limb-threatening thrombosis or whose symptoms fail to resolve with adequate anticoagulation. CVAD removal should be consider for patients with bacteremia, persistent symptoms despite anticoagulation, and if the CVAD is no longer needed. Superior vena cava filters should be avoided. Prospective studies are needed to define the optimal management of patients with or at risk for CRT.

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