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Pediatric interventional venous access
Peter G Chait1, Michael Temple, Bairbre Connolly
1Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Establishing venous access in critically ill children is crucial but difficult. Advances in imaging empower interventional radiologists to place short-term (peripherally inserted central catheters) and long-term (central venous lines, Port-a-catheters) venous access devices, improving pediatric patient care.
Area of Science:
- Pediatric Interventional Radiology
- Vascular Access Procedures
- Medical Imaging in Pediatrics
Background:
- Effective venous access is vital for administering therapies to sick children.
- Placement of venous access devices can be technically challenging in pediatric populations.
- Imaging advancements have significantly improved the success and safety of these procedures.
Purpose of the Study:
- To review the indications for venous access in children.
- To describe the techniques for placing short- and long-term venous access devices.
- To discuss potential complications and management strategies, including fragmented line retrieval.
Main Methods:
- Review of current literature and clinical practices regarding pediatric venous access.
- Discussion of imaging modalities utilized by interventional radiologists.
- Analysis of short-term (PICC) and long-term (CVL, Port-a-catheters) venous access devices.
Main Results:
- Interventional radiology offers solutions for challenging venous access in pediatric patients.
- Various imaging techniques facilitate precise device placement.
- Complications associated with venous access devices are discussed, alongside retrieval methods for fragmented lines.
Conclusions:
- Image-guided venous access by interventional radiologists is essential for sick children.
- Appropriate selection and placement of devices minimize risks.
- Management of complications, including fragmented lines, is a critical aspect of pediatric care.
Abstract:
Venous access for therapy in sick children is very important, but sometimes also extremely challenging. With several advances in imaging modalities, the interventional radiologist can certainly help in these situations. This article reviews the indications, technique, and complications related to short- (peripherally inserted central catheter) and long-term (central venous lines, Port-a-catheters) venous accesses in children. A brief commentary is also made about retrieval of fragmented lines.