Joint quality improvement guidelines for pediatric arterial access and arteriography: from the Societies of Interventional Radiology and Pediatric Radiology

Heran, Manraj K. S.; Marshalleck, Francis E.; Temple, Michael; Connolly, Bairbre; Towbin, Richard B.; Baskin, Kevin M.; Dubois, Josée; Hogan, Mark; Kundu, Sanjoy; Miller, Donald L.; Roebuck, Derek J.; Rose, Steven C.; Sacks, David; Sidhu, Manrita; Wallace, Michael J.; Zuckerman, Darryl A.; Cardella, John F.

doi:10.1007/s00247-009-1499-8

Cited by 36 publications

(17 citation statements)

References 105 publications

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“…No corresponding literature describes similar study of risk factors for CA in young children. 15,16 As a result, although previous and current literature on CA in children points to a low rate of complications, lower than that reported for adults, current clinical practice for this population is guided by assumptions among interventional neuroradiologists and vascular neurosurgeons regarding sources of complications in small children.…”

Section: Discussionmentioning

confidence: 86%

“…Heran et al defined 15 kg as a cutoff weight for higher access-related rates of complications. 15,16 Despite a trend toward higher rates of complications among patients who weighed less than 15 kg, the number of patients is too small to determine significance. The 2 patients with access-related injuries weighed 7 kg and 10.8 kg; the overall mean weight was 10.8 kg.…”

Section: Discussionmentioning

confidence: 99%

“…Current reports of risk factors for angiography in small children also largely draw on cardiac catheterization data; no corresponding literature specifically addresses cerebral procedures. 15,16 We therefore aimed to assess the complications and associated risk factors for CA specifically among young children. We used current technology, methods, and therapeutic indications to provide guidelines for accurate counseling of the parents/guardians of these patients and appropriate use of the procedure.…”

Section: ©Aans 2014mentioning

confidence: 99%

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Complications of cerebral angiography in children younger than 3 years of age

Hoffman¹,

Santillán²,

Rotman³

et al. 2014

PED

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Object The therapeutic potential for cerebral angiography (CA) in young children is expanding. However, its use in this patient population is limited by presumed higher complication rates among children. Therefore, to improve the accuracy of counseling of the parents/guardians of these patients and to identify modifiable risk factors, the authors evaluated complications after CA in young children. Methods The authors reviewed data for 309 consecutive cerebral angiograms obtained in 87 children younger than 36 months of age from 2004 to 2010 at a single institution. They analyzed demographics, diagnosis, angiographic findings, and complications. Results The patient population comprised 40 boys and 47 girls; mean age was 14.36 months (range 1–36 months) and mean weight was 10.8 kg (range 3.7–21.0 kg). For 292 of the 309 procedures, intraarterial chemotherapy was administered; the remaining 17 procedures were for vascular malformations, stroke, tumor embolization, and intracranial hemorrhage. The rate of neurological complications was 0.0%. The rate of nonneurological complications was 2.9%: 7 cases of contrast allergy or bronchospasm, 1 groin hematoma (body weight 7 kg), and 1 transient femoral artery occlusion (body weight 10.8 kg). The rate of radiographic complications was 1.3%: 1 case of transient asymptomatic intraarterial dissection and 3 cases of asymptomatic vasospasm. Postprocedural MRI was performed for 33.3% of patients with no evidence of ischemia. There were no delayed complications. Mean follow-up time was 16.6 months. No association was found between complications and age, duration of anesthesia, number of vessels catheterized, size of the sheath, or diagnostic versus interventional procedures. Despite a trend toward a higher rate of complications for patients who weighed less than 15 kg, this finding was not significant (p = 0.35). Conclusions The rate of complications for CA in young children is comparable to rates reported for older children and lower than rates reported for adults. When appropriately indicated, CA should not be omitted from the therapeutic strategy of children younger than 36 months of age.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: ©Aans 2014mentioning

confidence: 99%

See 1 more Smart Citation

Complications of cerebral angiography in children younger than 3 years of age

Hoffman¹,

Santillán²,

Rotman³

et al. 2014

PED

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“…In general, 2 ml kg -1 (to a maximum of 3 ml kg -1 ) is suggested for neonates, 2 ml kg -1 for infants, and thereafter 1-1.5 ml kg -1 (Pärtan 2013;Sorantin et al 2002Sorantin et al , 2013a (Table 3). Higher doses and higher iodine concentrations have been used for CT-angiography or interventional procedures, particularly cardiography and angiography, but this was associated with an increased incidence of contrast-induced nephropathy (Frush 2008;Kurian et al 2013;Heran et al 2010). Higher contrast agent doses therefore must be considered when risk versus benefit is being assessed for a particular patient and should be Older than 2 years 250-300 1.5…”

Section: Indicationsmentioning

confidence: 99%

Contrast Media Use in Pediatrics: Safety Issues

Riccabona

2014

Medical Radiology

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“…Magnetic resonance imaging (MRI) also is being considered for use during PIR procedures; however, considerable limitations exist in allowing this to become a practical tool outside the research setting. During angiography, the patient dose can be reduced by using patient shielding, removing the grid for infants, reducing the air gap between the image receptor and patient, and optimizing the source-to-skin distance [5].…”

Section: Radiation Protectionmentioning

confidence: 99%

Nonvascular Pediatric Interventional Radiology

Burrill

Heran

2012

Can Assoc Radiol J

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Interventional radiology procedures are increasingly in demand in both the adult and pediatric populations. Pediatric procedures mirror many of the adult procedures but with increased complexity due to considerations related to patient size and the requirements for sedation and radiation protection. This article reviews the various nonvascular pediatric interventional procedures and provides information on sedation and radiation protection. The aim is to provide a greater exposure to the possible treatment options for pediatric patients and to facilitate understanding of imaging after various interventions.

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Joint quality improvement guidelines for pediatric arterial access and arteriography: from the Societies of Interventional Radiology and Pediatric Radiology

Cited by 36 publications

References 105 publications

Complications of cerebral angiography in children younger than 3 years of age

Complications of cerebral angiography in children younger than 3 years of age

Contrast Media Use in Pediatrics: Safety Issues

Nonvascular Pediatric Interventional Radiology

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