The use of the internal thoracic vein for percutaneous central venous access in an infant

Area of Science:

• Pediatric Surgery
• Vascular Access
• Interventional Radiology

Background:

• Central venous catheterization is crucial for children requiring long-term parenteral nutrition.
• Thrombosis of central veins presents a significant challenge for venous access in pediatric patients.
• Alternative venous access routes are essential when standard options are unavailable.

Observation:

• A 2-year-old child with short bowel syndrome had chronically thrombosed jugular, subclavian, and femoral veins.
• The patient was dependent on parenteral nutrition, necessitating a reliable central venous access.
• Standard central venous access attempts were not feasible due to extensive venous thrombosis.

Findings:

• A tunneled central venous catheter was successfully placed percutaneously.
• The internal thoracic vein was utilized as an alternative access route.
• This approach provided a viable solution for central venous access in a complex pediatric case.

Implications:

• Percutaneous internal thoracic vein access is a feasible alternative for pediatric patients with central venous thrombosis.
• This technique expands options for children requiring parenteral nutrition when conventional routes fail.
• Successful implementation may improve outcomes and reduce complications associated with venous access challenges in pediatric patients.