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Long-term central venous access through the ovarian vein
1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
JPEN. Journal of Parenteral and Enteral Nutrition
|July 1, 1997
Summary
This case report details a novel technique for central venous access in patients dependent on parenteral nutrition. A lower midline laparotomy allowed for ovarian vein catheter placement when other central veins were thrombosed.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Parenteral nutrition (PN) necessitates long-term central venous access.
- Thrombosis of central veins, including the superior vena cava (SVC) and inferior vena cava (IVC), presents a significant challenge for PN patients.
- Alternative venous access routes are crucial for managing complex cases.
Observation:
- A patient requiring total parenteral nutrition developed extensive venous thrombosis, affecting both the SVC and infrarenal IVC.
- Standard central venous access sites were deemed unsuitable due to the existing thrombosis.
- The ovarian vein was identified as a potential and accessible route for catheter insertion.
Findings:
- A technique for establishing central venous access through the ovarian vein via a lower midline laparotomy is described.
- This approach facilitated the placement of a long-term indwelling catheter for parenteral nutrition delivery.
- Successful catheterization via the ovarian vein provided a viable solution for this complex clinical scenario.
Implications:
- Ovarian vein catheterization represents a feasible alternative for central venous access in patients with extensive central venous thrombosis.
- This technique may be particularly valuable for patients requiring long-term parenteral nutrition.
- Further research could explore the long-term efficacy and safety of this approach in similar patient populations.