Patency of neck veins following ultrasound-guided percutaneous Hickman line insertion

Abstract

We conclude that (1) complete venous occlusion is associated with younger age and CVC infection. (2) In our study, the venous occlusion rate of 3 % is significantly lower than the published series of either open cutdown or the landmark technique.

Risks of long-term port use in enzyme replacement therapy for lysosomal storage disorders

“…Newer topical vascular imaging techniques and percutaneous ultrasound vascular access tools may facilitate placement in very difficult patients [ 18 ]. In a pediatric cohort, use of the ultrasound-guided percutaneous technique meant that venous occlusion of the great veins (internal jugular, innominate, or superior vena cava) was exceptionally uncommon at <3% [ 19 ].Additionally, use of distraction techniques during the procedure can greatly reduce the pain and distress for children and adolescents [ 20 ].…”

“…To decrease the risk of complications in patients with LSD who are using TIVADs for long-term ERT, we recommend following best practices, such as ultrasound guidance to place central venous catheters [ [3] , [4] , [5] , 21 ], experienced surgical team and personnel [ 1 , 5 ], hand hygiene and barrier precautions, and regular examination for thrombus via ultrasounds [ 3 , 22 ] and of skin integrity over TIVAD sites. The major long-term risk for patients with a potentially lifelong requirement for venous access is occlusion of the great veins and thus consideration should be made from the start to avoid this occurring by using specialist teams of surgeons with an interest in vascular access [ 23 ] and the ultrasound-guided percutaneous approach [ 19 , 23 ]. With these measures and careful placement, monitoring, and confirmation of the need for TIVAD, specialists will be equipped to strive for optimal outcomes with ERT with minimal complications from long-term TIVAD use.…”

Hickman to central venous catheter: A case of difficult venous access in a child suffering from acute lymphoblastic leukemia

“…The incidence of venous occlusion following CVC insertion is higher, up to 25% with open cut-down and landmark-based techniques, whereas it is much lower (3%) for percutaneous ultrasound-guided techniques. [ 7 ] Hickman lines are associated with higher complication rates compared to a chemo port. [ 8 ] Use of ultrasound helps identifying central veins and reduces the risks of complications.…”

Right Device Assessment and Selection in Pediatrics

“…Large collateral veins will eventually develop in the neck when one or both of the internal jugular veins become occluded. Potential collateral veins include the anterior jugular and inferior thyroid veins and the jugular arch, which can often be used for vascular access if an established connection with the brachiocephalic vein and superior vena cava is formed (Lorenz et al 2001;Shankar et al 2002;Willetts et al 2000;Wragg et al 2014). The right and left brachiocephalic veins may remain patent in the presence of an ipsilateral jugular and subclavian occlusion.…”