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Transhepatic insertion of vascular dialysis catheters in children: a safe, life-prolonging procedure

E A Bergey1, R D Kaye, J Reyes

  • 1Department of Radiology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 USA.

Pediatric Radiology
|January 9, 1999
PubMed

Insights

Transhepatic insertion of large-bore catheters is a safe and effective alternative for children with blocked central veins needing dialysis or plasmapheresis. Careful catheter removal with track embolization is recommended to prevent bleeding.

Area of Science:

  • Pediatric Interventional Radiology
  • Vascular Access Procedures
  • Nephrology

Background:

  • Percutaneous central venous catheter (CVC) insertion has been standard since 1989.
  • Occluded central veins in children necessitate alternative access methods.
  • Transhepatic catheter insertion adapts percutaneous techniques for challenging pediatric cases.

Observation:

  • Three pediatric patients (ages 5, 11, 12) with occluded central veins required hemodialysis or plasmapheresis.
  • Transhepatic insertion of large-bore catheters was successfully performed in all patients.
  • Procedures utilized combined ultrasound guidance and fluoroscopy, with no immediate complications.

Findings:

  • Transhepatic insertion of large-bore catheters is technically feasible and safe in pediatric patients.
  • The procedure provides a viable vascular access solution when central veins are unavailable.
  • Successful outcomes were achieved in patients requiring critical interventions like dialysis.

Implications:

  • This technique offers a crucial alternative for pediatric patients with complex venous occlusions.
  • Ensuring safe catheter removal through track embolization is vital to prevent hemorrhage.
  • Expanded use of transhepatic catheterization can improve management of life-threatening conditions in children.
Abstract

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