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Venographic Assistance in Peripherally Inserted Central Catheter Placement in a Pediatric Patient: A Case Report
Yusuke Tokuda1,2, Hiro Nakao2, Shintaro Morooka2
1Department of Critical Care Medicine, National Center for Child Health and Development, Tokyo, JPN.
Insights
Peripherally inserted central catheters (PICCs) are crucial for pediatric long-term IV access. Venography aided successful PICC placement in a child with venous stenosis, overcoming insertion challenges.
Area of Science:
- Pediatric Medicine
- Vascular Access
- Interventional Radiology
Background:
- Peripherally inserted central catheters (PICCs) are widely used in pediatric patients for prolonged intravenous therapy.
- Common complications include pneumothorax and hemothorax, but venous stenosis or occlusion can impede catheter advancement.
Abstract:
Peripherally inserted central catheters (PICCs) are commonly used in pediatric patients for long-term IV access because of their ease of insertion and lower risk of complications such as pneumothorax or hemothorax. However, difficulties may arise when advancing the catheter due to venous stenosis or occlusion. We reported a pediatric case requiring prolonged antibiotic therapy for sacral osteomyelitis, in which PICC placement was initially unsuccessful because of resistance encountered during catheter advancement. Venography revealed significant venous stenosis, which allowed successful catheter placement after the guidewire was redirected into a patent vessel. This case highlighted the utility of venographic assistance in instances of PICC insertion failure.
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