Combined endovascular and surgical recanalization after central venous catheter-related obstructions

J Pediatr Surg. 2008 Jun;43(6):E21-4. doi: 10.1016/j.jpedsurg.2008.01.076.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Brachiocephalic Veins
  • Catheterization / adverse effects*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / methods
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Device Removal / methods
  • Digestive System Abnormalities / diagnosis
  • Digestive System Abnormalities / therapy
  • Equipment Failure
  • Follow-Up Studies
  • Humans
  • Infant
  • Parenteral Nutrition / adverse effects*
  • Parenteral Nutrition / methods
  • Reoperation
  • Risk Assessment
  • Short Bowel Syndrome / diagnosis
  • Short Bowel Syndrome / therapy
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / etiology
  • Venous Thrombosis / therapy*