Pediatric Traumas and Paradigm Shifts: The Necessary Adaption of the Steerable Microcatheter in Pediatric Interventional Radiology

Abstract

The use of traditionally available intra-arterial devices have historically been designed with the adult patient population in mind. Currently, there are not manufactured devices specifically tailored for use during pediatric interventional procedures, pressuring interventional operators to adapt commonplace and readily available devices for interventional management. Experienced interventional operators understand that pediatric and adult interventions can entail vastly different management, affecting patient care and outcomes. To address the pitfalls in pediatric interventional management, an accredited fellowship specifically for pediatric interventional radiology is available. However, devices must equally evolve with the training available in order to adequately address interventional management of the pediatric patient population. Interventional device innovation can be considered the initial step towards bridging the technical and procedural gaps necessary for refining pediatric intervention. The introduction of steerable microcatheters in interventional radiology has innovated procedural protocols, but has never been documented in pediatric patients until this time.

Pediatric abdominal arterial intervention using a steerable microcatheter through an introducer with 4-F outer diameter: report of two cases

“…A small number of studies have reported cases in which a steerable microcatheter with a distal diameter of 2.4-F (SwiftNINJA standard; Sumitomo Bakelite, Tokyo, Japan) was directly advanced via the femoral approach to a target organ without a diagnostic catheter, achieving successful arterial intervention: hepatic arterial infusion chemotherapy, uterine artery embolization, and arterial embolization for pediatric trauma [2] , [3] , [4] . The steerable tip of a steerable microcatheter plays a key role in increasing the operability of these interventions [2] .…”