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Combined endovascular and surgical recanalization after central venous catheter-related obstructions

Anthony S de Buys Roessingh1, Nathalie Portier-Marret, Stéphane Tercier

  • 1Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud CHUV, Lausanne, Switzerland. anthony.debuys-roessingh@chuv.ch

Journal of Pediatric Surgery
|June 19, 2008
PubMed

Insights

Central venous occlusion in infants, often from catheters, can cause serious complications. Retrograde recanalization successfully restored essential central venous access in two young patients.

Area of Science:

  • Pediatric Interventional Cardiology
  • Vascular Surgery
  • Neonatal Medicine

Background:

  • Central venous catheterization is crucial for neonatal total parenteral nutrition but carries risks.
  • Complications include sepsis and venous thrombosis, leading to loss of central venous access.
  • Chronic obstruction of brachiocephalic veins and superior vena cava syndrome pose significant challenges in infants.

Observation:

  • Two infants under one year old developed extensive central venous obstructions.
  • These obstructions led to superior vena cava syndrome, necessitating restored venous access for survival.
  • Patients required central venous access for total parenteral nutrition pending intestinal transplantation.

Findings:

  • Retrograde recanalization of the superior vena cava was successfully performed.
  • A pathway was created from the femoral vein to the right thyroid vein and right subclavian vein under general anesthesia.
  • This procedure effectively restored central venous access in both cases.

Implications:

  • Successful retrograde recanalization offers a viable solution for complex central venous occlusions in infants.
  • This technique can preserve vital central venous access for patients requiring long-term support, such as awaiting intestinal transplantation.
  • It highlights the potential for interventional procedures to manage severe catheter-related venous complications in neonates.

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