Developing a pediatric endovascular thrombolysis program: a single-center experience

Area of Science:

• Pediatric Medicine
• Interventional Radiology
• Hematology

Background:

• Deep venous thrombosis (DVT) is an increasing concern in children, carrying risks of pulmonary embolism and death.
• Post-thrombotic syndrome (PTS) following pediatric DVT can lead to chronic venous insufficiency with long-term adverse effects.
• Catheter-directed therapy (CDT) has shown promise in adults for reducing PTS, and its safety in adolescents is established.

Purpose of the Study:

• To establish a multidisciplinary pediatric endovascular thrombolysis program for managing DVT in children.
• To detail the development process and operational aspects of this specialized program.

Main Methods:

• Development of a multidisciplinary team including interventional radiology, pediatric hematology, critical care, anesthesia, and vascular surgery.
• Description of patient selection criteria, the endovascular therapy procedure, and comprehensive monitoring protocols (pre-, intra-, and post-procedure).
• Outline of follow-up management strategies for pediatric DVT patients treated with endovascular therapy.

Main Results:

• Successful institution of a pediatric endovascular thrombolysis program.
• Detailed description of the program's multidisciplinary structure and operational workflow.
• Experience with patient management, procedural aspects, and follow-up for pediatric DVT.

Conclusions:

• A multidisciplinary approach is essential for developing and implementing a successful pediatric endovascular thrombolysis program.
• This program provides a framework for managing pediatric DVT, potentially mitigating risks and long-term complications.
• The described program facilitates effective endovascular therapy for pediatric DVT, enhancing patient outcomes.