Technical factors and outcomes in pediatric central venous port placement

Shilati, Francesca M.; Raval, Mehul V.; Lautz, Timothy B.

doi:10.1016/j.jpedsurg.2021.02.055

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…The correlation between proceduralist experience and patient outcome for pediatric TIVAP insertion continues to be a subject of 24 and the median fluoroscopy time of 10 seconds was obviously shorter than that in other study. 8 Likewise, Oulego-Erroz et al 17 This result is consistent with other published literature on children reporting complication rates ranging from 0.15 to 0.9 per 1000 catheter-days. 25,26 However, the incidence of complications after TIVAP placement via the BCV approach in adults ranged from 2.83% to 5.08%, 21,22 with one article displaying a complication rate of 0.11 per 1000 catheter-days.…”

Section: Discussionsupporting

confidence: 82%

“…However, our surgeons were from the integrated medical union of People's Hospital, and we had extensive experience with hundreds of ultrasound‐guided BCV punctures for adult TIVAP procedures. In our children's population, no intraoperative complications occurred despite the small sample cohort, the average procedural time of 44.6 mins was comparable with the 41.7‐47 mins reported by Bawazir et al., 24 and the median fluoroscopy time of 10 seconds was obviously shorter than that in other study 8 . Likewise, Oulego‐Erroz et al 17 .…”

Section: Discussionsupporting

confidence: 80%

“…The correlation between proceduralist experience and patient outcome for pediatric TIVAP insertion continues to be a subject of investigation. Recently, a study from Shilati et al 8 . demonstrated that individual surgery volume and specialty training might influence the incidence of early revision or replacement with an inverse correlation.…”

Section: Discussionmentioning

confidence: 99%

“…The IJV approach has disadvantages of higher puncture point, smaller catheter radian, risk of misplacement, catheter bending and blockage, and patient discomfort due to longer catheter trajectory 7 ; whereas the landmark SCV access is prone to be kinking such as pinch-off syndrome, and has a relatively lower success rate at first attempt and a higher intraoperative conversion rate to a secondary site. 8 However, since the initial report of ultrasound-guided brachiocephalic vein (BCV) approach in the supraclavicular region by Breschan et al 9 in 2011, it has been widely used in adults, 10 children, [11][12][13] infants, 14,15 and even premature infants [16][17][18] for central venous catheters' (CVCs) insertion procedure.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Ding

Qiu

et al. 2022

Pediatric Blood & Cancer

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Background and objectives: To investigate the feasibility and safety of ultrasoundguided totally implantable venous access ports (TIVAPs) via the right brachiocephalic vein (BCV) in pediatric patients.Methods: A single-institute retrospective review was performed on 35 pediatric patients with predominantly hematological malignancies (88.6%) who underwent TIVAP implantation via ultrasound-guided right BCV approach from July 2018 to June 2021. The catheter tip was adjusted to be positioned at the cavoatrial junction under pulsed fluoroscopic guidance. Technical success rate, procedural information, and TIVAP-related complications were evaluated.Results: All the pediatric TIVAP devices were successfully implanted via right BCV access. Venous access was successful by first attempt in 32 children (91%), two cases (5.7%) required a second attempt, and one patient (2.9%) required a third attempt.The mean procedural time was 44.6 ± 6.4 minutes (range: 34-62 minutes). No intraoperative complications occurred. The average TIVAP indwelling time was 564 ± 208 days (range: 193-1014 days), with a cumulative 19,723 catheter-days. Overall, three patients (8.6%) experienced four postoperative complications (two cases of local hematoma and two catheter dysfunctions) at a rate of 0.2 per 1000 catheterdays. No other complications such as wound dehiscence, delayed incision healing, Abbreviations: BCV, brachiocephalic vein; CRBSI, catheter-related bloodstream infection; CRT, catheter-related thrombosis; CVC, central venous catheter; IJV, internal jugular vein; IQR, interquartile range; PICC, peripherally inserted central catheter; SCV, subclavian vein; TIVAP, totally implantable venous access port.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Ding

Qiu

et al. 2022

Pediatric Blood & Cancer

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“…Complications occurring during the insertion are well documented [ 2 , 4 , 5 ]. Significant research has been undertaken to reduce the incidence of these complications by focusing on the use of an ultrasound (US)-guided technique.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting mechanical complications of central venous access devices in children

et al. 2022

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Purpose Factors leading to mechanical complications following insertion of central venous access devices (CVADs) in children are poorly understood. We aimed to quantify the rates and elucidate the mechanisms of these complications. Methods Retrospective (2016–2021) review of children (< 18 years old) receiving a CVAD. Data, reported as number of cases (%) and median (IQR), were analysed by Fisher’s exact test, chi-squared test and logistic regression analysis. Results In total, 317 CVADs (245 children) were inserted. Median age was 5.0 (8.9) years, with 116 (47%) females. There were 226 (71%) implantable port devices and 91 (29%) Hickman lines. Overall, 54 (17%) lines had a mechanical complication after 0.4 (0.83) years from insertion: fracture 19 (6%), CVAD migration 14 (4.4%), occlusion 14 (4.4%), port displacement 6 (1.9%), and skin tethering to port device 1 (0.3%). Younger age and lower weight were associated with higher risk of complications (p < 0.0001). Hickman lines had a higher incidence of complications compared to implantable port devices [24/91 (26.3%) vs 30/226 (13.3%); p = 0.008]. Conclusion Mechanical complications occur in 17% of CVADs at a median of < 6 months after insertion. Risk factors include younger age and lower weight. Implantable port devices have a lower complications rate. Level of evidence Level 4: case-series with no comparison group.

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Role of Interventional Radiology in Pediatric Cancer Patients

Aguado

2022

Curr Oncol Rep

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Technical factors and outcomes in pediatric central venous port placement

Cited by 8 publications

References 10 publications

Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Factors affecting mechanical complications of central venous access devices in children

Role of Interventional Radiology in Pediatric Cancer Patients

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