title: Surgically assisted trans-hepatic anterior approach for central venous catheter placement: safety and efficacy.
abstract: We describe a child dependent on parenteral nutrition who developed loss of all conventional central venous catheter insertion sites coupled with very unusual collateralization due to extensive thrombosis of both the superior and inferior vena cava, including the azygos vein. We successfully achieved trans-hepatic anterior access to the infra-diaphragmatic vena cava. Since the success rate for this technique is low due to catheter dislodgement, the procedure was surgically assisted for increased safety and efficacy.
authors.affiliation: Department of Surgery and Transplantation Center, Liver Unit, Bambino Gesu Children's Hospital, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Diamanti
authors.forename: Massimo
authors.initials: M
authors.lastname: Rollo
authors.forename: Lidia
authors.initials: L
authors.lastname: Monti
authors.forename: Manila
authors.initials: M
authors.lastname: Candusso
authors.forename: Jean
authors.initials: J
authors.lastname: de Ville de Goyet
mesh_terms: D000792:Angiography / Q000379:methods; D001401:Azygos Vein / Q000601:surgery; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D004868:Equipment Failure; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total / Q000295:instrumentation / Q000379:methods*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*