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Transiliac catheterization of the inferior vena cava for long-term venous access in children
1Department of Pediatric Surgery, Kumamoto University Medical School, Honjo 1-1-1 Kumamoto City, 860 Japan.
Insights
For children needing long-term central venous access, the iliac vein offers an alternative when the vena cava is blocked. A retroperitoneal approach to the external iliac vein is a simple and effective method for port placement.
Area of Science:
- Vascular surgery
- Pediatric interventional radiology
- Vascular access
Background:
- Prolonged central venous catheterization in children can lead to superior and inferior vena cava thrombosis or stenosis.
- Difficult central venous access poses significant challenges in pediatric patients requiring long-term treatment.
- Alternative venous access routes are crucial for managing complex cases.
Observation:
- A patient with superior vena cava thrombosis required central venous access.
- The external iliac vein was accessed via a retroperitoneal approach for implantable port placement.
- This surgical technique was found to be straightforward and did not require specialized equipment or patient positioning.
Findings:
- The retroperitoneal approach to the external iliac vein is a viable alternative for central venous access in pediatric patients with vena cava obstruction.
- Implantable ports can be successfully placed using this technique.
- The procedure is technically easy to perform.
Implications:
- This approach expands options for securing central venous access in challenging pediatric cases.
- It may reduce the need for more complex or higher-risk procedures.
- Facilitates long-term venous access for critically ill children.
Abstract:
In infants and children requiring prolonged, multiple central venous (CV) catheterizations, the superior (SVC) and inferior vena cava may become thrombosed or stenotic, making CV access a difficult problem. Use of the iliac vein may be an acceptable alternative. We report a patient with thrombosis of the SVC in whom the external iliac vein was accessed through a retroperitoneal approach for placement of an implantable port. This technique is easy to perform, and there are no special materials or patient positioning required.