Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;69(10):e29911.
doi: 10.1002/pbc.29911. Epub 2022 Jul 26.

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

Wei Ding  1 , Lu Qiu  2 , Tianyu Li  3 , Weiwei Su  4 , Qian Yu  5 , Tianshen Hu  6 , Chunxin Wang  7 , Chen Fan  1 , Weidong Wang  1
Affiliations

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

Wei Ding et al. Pediatr Blood Cancer. 2022 Oct.

Abstract

Background and objectives: To investigate the feasibility and safety of ultrasound-guided 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 catheter-days. No other complications such as wound dehiscence, delayed incision healing, catheter-related thrombosis (CRT), catheter malposition/fracture, surgical site infection, catheter-related bloodstream infection (CRBSI), pinch-off syndrome, and drug extravasation were observed during follow-up.

Conclusions: Ultrasound-guided right BCV access for TIVAP placement in pediatric patients appears to be technically feasible, safe, and effective. Further large-sample, prospective studies are warranted.

Keywords: brachiocephalic vein; feasibility; pediatric patient; safety; totally implantable venous access port; ultrasound guided.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. Bhakta N, Force LM, Allemani C, et al. Childhood cancer burden: a review of global estimates. Lancet Oncol. 2019;20:e42-e53.
    1. Beck O, Muensterer O, Hofmann S, et al. Central venous access devices (CVAD) in pediatric oncology patients - a single-center retrospective study over more than 9 years. Front Pediatr. 2019;7:260.
    1. Ullman AJ, Gibson V, Takashima MD, et al. Pediatric central venous access devices: practice, performance, and costs. Pediatr Res. 2022;8. https://doi.org/10.1038/s41390-022-01977-1
    1. Gonella S, Antonuzzo A, Bossi P. Peripherally or centrally inserted central catheters: what is the best vascular access device for cancer patients? Support Care Cancer. 2021;29:2803-2806.
    1. Wang K, Zhou Y, Huang N, Lu Z, Zhang X. Peripherally inserted central catheter versus totally implanted venous port for delivering medium- to long-term chemotherapy: a cost-effectiveness analysis based on propensity score matching. J Vasc Access. 2022;23:365-374.

LinkOut - more resources