Combined endovascular and surgical recanalization after central venous catheter-related obstructions.
Central venous occlusion in children is a challenging problem that can occur after a central venous catheter insertion. Long-term catheter-related complications include sepsis and venous thrombosis with consequent loss of central access. We describe 2 cases of children younger than 1 year who were dependent on a central venous catheter for total parenteral nutrition. They developed a chronic extensive obstruction of the right and left brachiocephalic veins with a superior vena cava syndrome. The patients' survival was dependent on the restoration of central venous access until the planned intestinal transplantation could be performed. Retrograde recanalization of the superior vena cava was successfully achieved using a pathway created under general anesthesia from the femoral vein to, respectively, the right thyroid vein and the right subclavian vein.
de Buys Roessingh
Anthony S
AS
Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud CHUV, Lausanne, Switzerland. anthony.debuys-roessingh@chuv.ch
Portier-Marret
Nathalie
N
Tercier
Stéphane
S
Qanadli
Salah D
SD
Joseph
Jean-Marc
JM
D000792:Angiography; D016121:Brachiocephalic Veins; D002404:Catheterization / Q000009:adverse effects*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D020878:Device Removal / Q000379:methods; D004065:Digestive System Abnormalities / Q000175:diagnosis / Q000628:therapy; D004868:Equipment Failure; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010288:Parenteral Nutrition / Q000009:adverse effects* / Q000379:methods; D012086:Reoperation; D018570:Risk Assessment; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*