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Ultrasound assessment of thrombotic complications in pediatric patients with
tunneled central venous catheters
#MMPMID26673005
Tomaszewski M
; Kosiak W
; Irga N
; Po?czy?ska K
J Ultrason
2013[Dec]; 13
(55
): 451-9
PMID26673005
show ga
Central venous access consists in inserting a vascular catheter to the vena cava
and placing its tip in the vicinity of the opening to the right atrium. In the
patients of the Clinic of Pediatrics, Hematology and Oncology at the Academic
Clinical Centre of the Medical University in Gda?sk, such implantation procedures
are conducted 40-50 times in a year using Broviac/Hickman catheters that are
placed in the subclavian vein. In the Ultrasound and Biopsy Laboratory at the
clinic mentioned above, approximately 200-250 examinations have been conducted
since 2005 to assess the central venous access. Implantation of a catheter
considerably increases the comfort of patients who require a long-term venous
access. Nevertheless, it is an invasive procedure, burdened with a risk of
numerous, early and late complications. The late complications are associated
with implanted catheters and include catheter-related thrombosis. The aim of this
paper was to present three patients of the Clinic of Pediatrics, Hematology and
Oncology at the Academic Clinical Centre of the Medical University in Gda?sk, in
whom thrombotic complications occurred as a result of long-term central venous
catheters. The paper also discusses the possibilities of using sonography in the
assessment of such complications. In the presented patients, it was possible to
determine the size and localization of a thrombus which enabled effective
treatment in two cases. The pathomechanism of catheter-related thrombosis was
explained and the risk factors of such complications were discussed. The
attention was paid to the necessity of conducting ultrasound examinations in
pediatric patients with inserted catheters as soon as the first symptoms of
thrombosis appear. Based on own observations and despite the lack of validation
of ultrasound imaging in the assessment of central catheters, we believe that
this method is highly promising and can be recommended for the assessment of
thrombotic complications in pediatric patients with central venous catheters.
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