J Korean Soc Radiol.  2015 Feb;72(2):101-107. 10.3348/jksr.2015.72.2.101.

Radiologically-Placed Venous Ports in Children Under Venous Anesthesia

• Jang JY
• Jeon UB
• Choo KS
• Hwang JY
• Kim YW
• Lee YJ
• Nam SO
• Lim YT

• KMID: 2002805
• DOI: http://doi.org/10.3348/jksr.2015.72.2.101

Abstract

PURPOSE
To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia.
MATERIALS AND METHODS
Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed.
RESULTS
The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days).
CONCLUSION
Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

MeSH Terms

Anesthesia*
Body Weight
Catheters
Child*
Fever
Follow-Up Studies
Humans
Jugular Veins
Sepsis
Subclavian Vein

Figure

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  Fig. 1 A 3-year-old girl with hemophagocytic syndrome is refered for chemoport insertion. A. Right internal jugular vein is used for access route. Spot image shows a catheter tip is located at superior vena cava level, that means higher than usual location. Chemoport had been used for 177 days. B. Spot image of patient just before removal shows kinking of the catheter at the neck area (arrow). C. Right subclavian vein is used for access route at 2nd insertion. A right subclavian central catheter is changed into chemoport. The port was removed after treatment termination. The catheter has been used about 1 year. D. Left subclavian vein is used at 3rd insertion. Guide wire is inserted into central catheter and changed into peel-away sheath. Spot image after port insertion shows catheter tip is located slightly above cavoatrial junction (arrow), and port did not function. E. Catheter tip is pulled by Goose neck snare with transfemoral approach. F. After reposition of catheter tip, port functions well and has been used during 1-year follow-up period.

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