E A Bergey1, R D Kaye, J Reyes, R B Towbin. 1. Department of Radiology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 USA.
Abstract
INTRODUCTION: Central venous catheters (CVC) have been inserted percutaneously since 1989. This technique has been adapted for transhepatic insertion of large-bore catheters in children with occluded central veins. MATERIALS AND METHODS: Three children aged 5, 11, and 12 years required hemodialysis or plasmaphoresis for treatment of life-threatening conditions. All central veins were occluded, thus transhepatic insertion of a large-bore catheter was necessary. All children underwent successful placement using a combination of ultrasound guidance and fluoroscopy. No complications occurred. DISCUSSION: Transhepatic insertion of large-bore catheters can be performed safely in children. Catheter removal should be accompanied by track embolization to prevent exsanguinating hemorrhage. CONCLUSION: Transhepatic insertion of dialysis catheters is a safe alternative in children with occluded central veins.
INTRODUCTION: Central venous catheters (CVC) have been inserted percutaneously since 1989. This technique has been adapted for transhepatic insertion of large-bore catheters in children with occluded central veins. MATERIALS AND METHODS: Three children aged 5, 11, and 12 years required hemodialysis or plasmaphoresis for treatment of life-threatening conditions. All central veins were occluded, thus transhepatic insertion of a large-bore catheter was necessary. All children underwent successful placement using a combination of ultrasound guidance and fluoroscopy. No complications occurred. DISCUSSION: Transhepatic insertion of large-bore catheters can be performed safely in children. Catheter removal should be accompanied by track embolization to prevent exsanguinating hemorrhage. CONCLUSION: Transhepatic insertion of dialysis catheters is a safe alternative in children with occluded central veins.