Use of Vascular Ports for Long-Term Apheresis in Children

Chand, Rajat; Sertic, Madeleine; Nemec, R; Tomlin, Keturah; Connolly, Bairbre

doi:10.1016/j.jvir.2015.05.023

Cited by 10 publications

(21 citation statements)

References 12 publications

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“…In many institutions that use ports, tissue plasminogen activator is instilled for 30 to 45 minutes before performing TA when sluggish flow is observed or suspected from previous procedures. In children, similar complications were noted in a small study of eight pediatric patients . Access difficulties (3%), treatment delays (4%), bleeding, and bruising were common complications of port use in this group.…”

Section: Av Graftssupporting

confidence: 74%

Vascular access for therapeutic plasma exchange

Ipe

Marques

2018

Transfusion

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Therapeutic plasma exchange is an apheresis modality in which plasma is separated from the blood cellular components ex vivo, discarded, and replaced with an isosmotic fluid (most commonly 5% albumin) to maintain appropriate oncotic pressure in the patient. Therapeutic plasma exchange is used in the treatment of many diseases and indications. The recent seventh edition of the American Society for Apheresis guidelines indicates approximately 72 diseases and 116 indications for which therapeutic plasma exchange may be effective. One of the critical aspects for the successful performance of therapeutic plasma exchange is appropriate vascular access to provide high blood flow for the collection and return phases of the procedure, especially because most patients who need therapeutic plasma exchange will require more than one treatment over days to weeks. This article provides an overview of the characteristics of therapeutic plasma exchange, the clinical diseases and indications that may be treated with therapeutic plasma exchange, and the different types of vascular access employed, with their advantages and disadvantages. The latter may include peripheral venous access and intravascular or implantable access devices, such as arteriovenous grafts and fistulas, central venous catheters, and central venous catheters tunneled with ports.

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Section: Av Graftssupporting

confidence: 74%

Vascular access for therapeutic plasma exchange

Ipe

Marques

2018

Transfusion

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“…Personal protective equipment should be used for all patients and isolation if necessary. 74 It is our practice to defer starting TPE for 24 hours after any surgical procedure, including line insertion, to minimize the risks of bleeding and cardiovascular instability. If a CVC is required, the internal jugular vein is usually preferred; femoral catheters limit mobility and may pose a greater infection risk; subclavian catheters are more prone to obstruction and displacement.…”

Section: Preparation For Treatmentmentioning

confidence: 99%

Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm

Eyre

Hacohen

Barton

et al. 2018

Develop Med Child Neuro

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“…Single‐lumen and double‐lumen ports are available for placement. High‐flow ports have been used for apheresis in adults and children . New designs of subcutaneous implanted ports can tolerate the high flows required for therapeutic apheresis.…”

Section: Indications and Optionsmentioning

confidence: 99%

“…Advantages over external lines include infection rates and improved quality of life. Disadvantages include painful, large‐bore needle puncture of the reservoir for each treatment …”

Section: Indications and Optionsmentioning

confidence: 99%

Intravascular access devices from an interventional radiology perspective: indications, implantation techniques, and optimizing patency

Lee

Ramaswamy

2018

Transfusion

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Central venous access has become invaluable in the treatment of patients with a wide array of acute and chronic disease entities. Central venous catheters provide durable, short‐term and long‐term access solutions while saving the patient from repeated peripheral needle sticks. Central venous catheters include: non‐tunneled central venous catheters, tunneled central venous catheters, and port catheters. Typically, the placement of a central venous catheter is performed by Vascular and Interventional Radiologists. The purpose of this article is to familiarize the reader with the role of Interventional Radiology in the placement and management of intravascular or implantable access devices, with a focus on discussing indications for central venous catheter placement, implantation techniques, potential complications, and management of catheter dysfunction.

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Use of Vascular Ports for Long-Term Apheresis in Children

Cited by 10 publications

References 12 publications

Vascular access for therapeutic plasma exchange

Vascular access for therapeutic plasma exchange

Therapeutic plasma exchange in paediatric neurology: a critical review and proposed treatment algorithm

Intravascular access devices from an interventional radiology perspective: indications, implantation techniques, and optimizing patency

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