Related Experiment Videos
Hickman catheter embolism in a child during stem cell transplantation
Parvez Ahmed1, Badshah Khan, Khalil Ullah
1Armed Forces Bone Marrow Transplant Center, Rawalpindi. parvez101@yahoo.com
Insights
A Hickman catheter embolism occurred in a child undergoing stem cell transplant for aplastic anemia. The pulmonary embolism was successfully removed via midsternostomy, allowing the child
Area of Science:
- Hematology
- Pediatric Oncology
- Surgical Complications
Background:
- Central venous catheters, such as Hickman catheters, are essential for stem cell transplantation, providing venous access.
- These catheters are typically placed in the superior vena cava or right atrium.
- Complications, including catheter embolism, can arise during catheter removal.
Observation:
- A 5-year-old patient diagnosed with severe aplastic anemia underwent a successful peripheral blood stem cell transplant.
- During an attempted removal, the Hickman catheter embolized into the pulmonary circulation.
- The patient experienced no immediate adverse effects from the embolism prior to intervention.
Findings:
- The pulmonary embolism caused by the dislodged Hickman catheter was successfully managed and removed via a midsternostomy procedure.
- The patient achieved complete hematological recovery and successful engraftment post-transplant.
- The child remains in sustained remission and is in normal health 218 days after the procedure.
Implications:
- This case highlights the potential for catheter-related complications in pediatric stem cell transplant recipients.
- Surgical intervention, like midsternostomy, can be a safe and effective method for managing catheter embolism.
- Early recognition and prompt management are crucial for favorable outcomes in pediatric stem cell transplantation, even in the presence of procedural complications.
Abstract:
The majority of stem cell recipients rely on indwelling central venous catheters situated in superior vena cava or right atrium. Semi-permanent tunneled silicone rubber Hickman catheters are widely used to provide durable central venous access for patients undergoing stem cell transplantation. A case of 5 years old child with diagnosis of severe aplastic anemia is reported. The patient received peripheral blood stem cells (PBSC) and had successful engraftment with complete hematological recovery. He had Hickman catheter embolism in the pulmonary circulation following unsuccessful attempt to remove the line. The catheter was successfully removed by midsternostomy operation. The child is normal with sustained remission on day +218 post stem cell transplant.