Percutaneous translumbar inferior vena cava catheter placement for long-term hemodialysis treatment

Area of Science:

• Vascular Surgery
• Pediatric Nephrology
• Interventional Radiology

Background:

• Central venous access is crucial for long-term dialysis, but challenges arise when traditional sites (e.g., subclavian, internal jugular, femoral veins) become unavailable due to occlusion.
• Pediatric patients with end-stage renal disease often face difficulties securing reliable venous access for hemodialysis, necessitating alternative strategies.

Observation:

• A pediatric patient with occluded traditional venous access sites required a durable solution for long-term hemodialysis.
• The inferior vena cava, previously utilized in adults, was considered as a potential access site in the pediatric literature.

Findings:

• A percutaneous translumbar approach was successfully employed to place a central venous catheter into the inferior vena cava in a pediatric patient.
• The catheter remained functional for nearly two years, facilitating essential dialysis treatments until the patient underwent a successful renal transplant.

Implications:

• This case demonstrates the feasibility and efficacy of using the inferior vena cava via a translumbar approach for long-term central venous access in pediatric patients.
• This technique expands the options for venous access in pediatric nephrology, particularly for patients with complex venous anatomy or occlusive disease.
• Further research and case series are warranted to establish the safety and long-term outcomes of this approach in the pediatric population.