Histological changes of the unligated vein wall adjacent to the central venous catheter after open cutdown in rats

Kim, Seongyup; Kim, Younglim; Moon, Sun-Young

doi:10.1016/j.jpedsurg.2015.04.019

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…33 Last but not least, in the event of repeated insertions, venous cutdown is inevitably associated with a progressive depletion of the vascular patrimony due to venous thrombosis and/or stenosis. [34][35][36][37] Venous cutdown is currently replaced by ultrasound-guided techniques, which are safer, more effective and more cost-effective. [38][39][40] Today, the gold-standard in terms of technique of CVAD insertion is represented by the ultrasound-guided percutaneous technique, 3,[41][42][43] which is based on ultrasound (US) use to locate the vein, study its characteristics (course, caliber, presence of valves / endoluminal formations), measure the distance of the same from the skin surface, direct the path of the needle and also control the introduction of the guide wire in real time.…”

Section: Indications For Insertion and Selection Of The Cvadmentioning

confidence: 99%

Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease

et al. 2020

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Introduction: Central venous accesses devices (CVADs) have a fundamental importance for diagnostic and therapeutic purposes in pediatric onco-hematological patients. The treatment of pediatric onco-hematological diseases is complex and requires the use of integrated multimodal therapies. Long-lasting and safe central venous access is therefore a cornerstone for any successful treatment. Methods: The aim of this work is to define pediatric guidelines about the management of CVADs in onco-hematology. A panel of experts belonging to the working groups on Infections and Supportive Therapy, Surgery and Nursing of the Italian Pediatric Hematology Oncology Association (AIEOP) revised the scientific literature systematically, scored the level of evidence and prepared these guidelines. The content of the following guidelines was approved by the Scientific Board of AIEOP. Results and Conclusions: Important innovations have been developed recently in the field of CVADs, leading to new insertion methods, new materials and new strategy in the overall management of the device, especially in the adult population. These guidelines recommend how to apply these innovations in the pediatric population, and are directed to all physicians, nurses and health personnel active in the daily management of CVADs. Their aim is to update the knowledge on CVAD and improve the standard of care in pediatric patients with malignancies.

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Section: Indications For Insertion and Selection Of The Cvadmentioning

confidence: 99%

Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease

et al. 2020

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“…It is noteworthy that the lead-induced histological changes of the vein wall appear to be similar to the neointimal formation associated with the insertion of a central venous catheter (catheter-related sheath) [124][125][126][127]. This is hardly surprising since central venous catheters and ICED leads share similar architectural properties such as a tubular silicone coating and presumably similar mechanics at the implant/vessel interface.…”

Section: Characterization and Etiology Of Fibrotic Lead Encapsulationmentioning

confidence: 84%

Neointimal fibrotic lead encapsulation – Clinical challenges and demands for implantable cardiac electronic devices

Keiler

Schulze

Sombetzki

et al. 2017

Journal of Cardiology

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Every tenth patient with a cardiac pacemaker or implantable cardioverter-defibrillator implanted is expected to have at least one lead problem in his lifetime. However, transvenous leads are often difficult to remove due to thrombotic obstruction or extensive neointimal fibrotic ingrowth. Despite its clinical significance, knowledge on lead-induced vascular fibrosis and neointimal lead encapsulation is sparse. Although leadless pacemakers are already available, their clinical operating range is limited. Therefore, lead/tissue interactions must be further improved in order to improve lead removals in particular. The published data on the coherences and issues related to lead associated vascular fibrosis and neointimal lead encapsulation are reviewed and discussed in this paper.

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“…In our previous study, proliferation of SMCs was first identified 1 week after open cutdown CVC placement, stabilizing by 4-week postprocedure [ 4 ]. As shown in SMC counts in current study, SMC counts were significantly reduced in the treatment group at early postoperative period (1 and 2 weeks) when SMC proliferation was active, whereas the counts were similar between groups after postoperative 4 weeks when SMC proliferation was stabilized.…”

Section: Discussionmentioning

confidence: 99%

“…The control group (n = 16) was defined as rats that only underwent cutdown CVC placement, while the treatment group (n = 16) comprised rats that received paclitaxel after cutdown. Overall, the materials and methods utilized in this study were identical to those used in our previous investigation [ 4 ], with the exception of paclitaxel application in the treatment group of the current study.…”

Section: Methodsmentioning

confidence: 99%

“…We previously conducted a qualitative analysis of the serial histological changes in the unligated external jugular vein (EJV) wall in rats after open cutdown, including their interactions with the pericatheter sleeve. Our study demonstrated that circumferential neointimal hyperplasia in the vein and consequent luminal narrowing were caused by smooth muscle cell (SMC) activation, proliferation, and infiltration into the pericatheter sleeve [ 4 ]. Having examined the histopathological changes that lead to neointimal hyperplasia, investigation of a method to prevent this irreversible complication in a similar subject group was warranted.…”

Section: Introductionmentioning

confidence: 99%

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Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats

Kim

Hwang

et al. 2017

Ann Surg Treat Res

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PurposeInhibitory effect of paclitaxel on neointimal hyperplasia after open cutdown has not been elucidated.MethodsFor the control group (n = 16), silicone 2.7-Fr catheters were placed via the right external jugular vein with the cutdown method. For the treatment group (n = 16), a mixture of 0.65 mg of paclitaxel and 1 mL of fibrin glue was infiltrated around the exposed vein after cutdown. After scheduled intervals (1, 2, 4, and 8 weeks), the vein segment was harvested and morphometric analysis was performed on cross-sections.ResultsProliferation of smooth muscle cell (SMC) was strongly suppressed in the treatment group, and the ratio of neointima to vein wall was significantly reduced in the treatment group (8 weeks; 0.63 ± 0.08 vs. 0.2 ± 0.08, P < 0.05). Luminal patency was significantly more preserved in the treatment group, and the luminal area was significantly wider in the paclitaxel-treated group compared to the control group (8 weeks; 1.91 ± 0.43 mm2 vs. 5.1 ± 0.43 mm2, P < 0.05). Mean SMC counts measured at 1 and 2 weeks after cutdown were significantly lower in the treatment group (2 weeks; 115 ± 22 vs. 62 ± 22). Paclitaxel was undetectable in systemic circulation (<10 ng/mL).ConclusionSustained perivascular delivery of paclitaxel with fibrin glue was effective in inhibiting neointimal hyperplasia in rat jugular vein after open cutdown.

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Histological changes of the unligated vein wall adjacent to the central venous catheter after open cutdown in rats

Cited by 10 publications

References 22 publications

Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease

Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease

Neointimal fibrotic lead encapsulation – Clinical challenges and demands for implantable cardiac electronic devices

Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats

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