Patency of common carotid artery and internal jugular vein after a simple vessel sparing cannulation for extracorporeal membrane oxygenation support

Kürklüoğlu, Mustafa; Badia, Sara; Peer, Syed Murfad; Jonas, Richard A.; Shankar, Venkat; Sinha, Pranava

doi:10.1016/j.jpedsurg.2017.08.001

Cited by 14 publications

(15 citation statements)

References 14 publications

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“…Early experiences with techniques for managing distal limb ischemia, such as the insertion of distal perfusion catheters with PERC or OPEN access in pediatrics, demonstrate feasibility but have not demonstrated definitive improvement in clinical outcomes (25, 26). More granular data, as may be obtained through multicenter retrospective reviews outside of registry data, is needed for detailed analyses of the use of distal perfusion techniques and more importantly, for evaluation of vessel patency and usability following decannulation (27, 28).…”

Section: Discussionmentioning

confidence: 99%

Comparing Percutaneous to Open Access for Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

Cairo¹,

Arbuthnot

Boomer

et al. 2018

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 99%

Comparing Percutaneous to Open Access for Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

Cairo¹,

Arbuthnot

Boomer

et al. 2018

Pediatric Critical Care Medicine

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“…A recent study of infants except for newborns showed that approximately half of the RCCAs were patent after repair and could be used for intubation to perform ECMO again ( 13 ). Moreover, the duration of ECMO was shorter in patients whose RCCA was patent after repair than in those whose RCCA was not ( 34 ), which may be associated with less injury in the arterial intima caused by a shorter duration of ECMO ( 35 ). Tissue biopsies have suggested that circular transmural necrosis (CTN) mainly characterized by vessel wall necrosis and elastic fiber fragmentation was common surrounding the catheterization site, and it was correlated with the range of CTN and the duration of ECMO.…”

Section: Hemodynamics After Ecmomentioning

confidence: 99%

ECMO in neonates: The association between cerebral hemodynamics with neurological function

Mao

et al. 2022

Front. Pediatr.

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Extracorporeal membrane oxygenation (ECMO) is a superior life support technology, commonly employed in critical patients with severe respiratory or hemodynamic failure to provide effective respiratory and circulatory support, which is especially recommended for the treatment of critical neonates. However, the vascular management of neonates with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still under controversy. Reconstruction or ligation for the right common carotid artery (RCCA) after ECMO is inconclusive. This review summarized the existed studies on hemodynamics and neurological function after vascular ligation or reconstruction hoping to provide better strategies for vessel management in newborns after ECMO. After reconstruction, the right cerebral blood flow can increase immediately, and the normal blood supply can be restored rapidly. But the reconstructed vessel may be occluded and stenotic in long-term follow-ups. Ligation may cause lateralization damage, but there could be no significant effect owing to the establishment of collateral circulation. The completion of the circle of Willis, the congenital anomalies of cerebral or cervical vasculature, the duration of ECMO, and the vascular condition at the site of arterial catheterization should be assessed carefully before making the decision. It is also necessary to follow up on the reconstructed vessel sustainability, and the association between cerebral hemodynamics and neurological function requires further large-scale multi-center studies.

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“…A 6/0 polypropylene (Prolene, Ethicon, Somerville, NJ, USA) purse string suture was placed at the ventral side of the IJV, and the vessel was opened in the center along its long axis with a no. 11 blade scalpel (5). The correct position of the catheter's tip was determined with real-time fluoroscopy (6), and the catheter was secured with a purse string suture.…”

Section: Methodsmentioning

confidence: 99%

“…For the implantation, a midsized vein, such as the subclavian, cephalic, internal jugular vein (IJV), or external jugular vein, is needed (4). In order to maintain the vein's function, a vessel-sparing technique is used to place an HC or Port in the IJV (5).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up Examination of the Internal Jugular Vein After Vessel-Sparing Implantation of a Hickman Catheter or Port Catheter

et al. 2019

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Introduction: Both a Hickman catheter (HC) and port catheter (Port) can be inserted either percutaneously by the Seldinger technique or by surgical venous cut-down. Catheters are inserted with a vessel-sparing technique when they are placed in the internal jugular vein (IJV) by venous cut-down. Although this technique is common, data are sparse regarding the vessel's state at long-term follow-up. This study was aimed at determining the flow pattern and constitution of the IJV after vessel-sparing implantation of an HC or Port and comparing the outcomes to those of implantation with the Seldinger technique.Methods: One hundred children (58 boys, 42 girls) between 33 days and 18 years of age who underwent a vessel-sparing implantation of an HC or Port in the IJV were prospectively included. All patients underwent surgical venous cut-down at a single institution. Patency and shape of the IJV were determined by ultrasound and categorized according to 2 possible outcomes: relevant alteration (including occlusion of the IJV) and no relevant alteration, with relevant alteration defined as changes that caused an altered flow pattern.Results: Median age was 6 years at the time of operation, and the median indwelling time of catheters was 271 days. Twenty-two of our patients (22%) showed relevant alterations. These changes included high-grade stenosis or lesion in 13 patients (13%) and occlusion in 9 patients (9%). There were no operation-associated complications, such as pneumothorax, hematopericardium, or accidental puncture of the carotid artery. Statistical analysis did not reveal any specific parameter as a risk factor for relevant structural abnormalities.Discussion: In a comparison of our data to the literature, venous cut-down showed an alteration rate of 26% and a patency rate of 85%, whereas the Seldinger technique was found to cause alteration in 15%, with a patency rate of 97% but a successful placement rate of only 90.3–91.6%.Conclusion: The indication for long-term catheter placement may determine which method is preferable. A child who is likely to need more catheters in the future might benefit from the Seldinger technique, since there is a higher chance of long-term patency of the vessel. A patient undergoing chemotherapy might benefit more from the surgical venous cut-down with less placement-associated complications.

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Patency of common carotid artery and internal jugular vein after a simple vessel sparing cannulation for extracorporeal membrane oxygenation support

Cited by 14 publications

References 14 publications

Comparing Percutaneous to Open Access for Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

Comparing Percutaneous to Open Access for Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure

ECMO in neonates: The association between cerebral hemodynamics with neurological function

Long-Term Follow-Up Examination of the Internal Jugular Vein After Vessel-Sparing Implantation of a Hickman Catheter or Port Catheter

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