Vasc Spec Int.  2017 Sep;33(3):108-111. 10.5758/vsi.2017.33.3.108.

Usefulness of Percutaneous Puncture in Insertion of Totally Implantable Venous Access Devices in Pediatric Patients

• Choi JS
• Park KM
• Jung S
• Hong KC
• Jeon YS
• Cho SG
• Choe YM

• KMID: 2396190
• DOI: http://doi.org/10.5758/vsi.2017.33.3.108

Abstract

PURPOSE
Totally implantable venous access devices (TIVADs) are commonly used in pediatrics for the administration of chemotherapy, antibiotics, or parenteral nutrition. TIVADs can be implanted using various techniques, including surgical cutdown (SC) and percutaneous puncture (PP). Recently, percutaneous TIVAD became popular in adults, but studies comparing between PP and SC group in pediatric patients are rare.
MATERIALS AND METHODS
Data were collected and analyzed retrospectively from 23 patients who underwent TIVAD at a single institution between January 2013 and December 2015. We examined the clinical characteristics, insertion techniques, and clinical outcome. We divided the patients into 2 groups and compared PP with ultrasonography and SC using the insertion technique. We compared success rate, procedural time, and the patency rate between the 2 groups.
RESULTS
Eleven TIVADS were inserted using PP, and 12 TIVADs were inserted using SC. No statistically significant difference in characteristics was found between the 2 groups. The procedural time in the PP group was shorter than that in the SC group, but the difference was not statistically significant (P=0.685). During follow-up, 1 patient in the SC group had an occlusion, and 1 patient in the PP group had an infection.
CONCLUSION
PP of the internal jugular vein with ultrasonography appears to be the method of choice for TIVAD insertion owing to its similar success rate in terms of implantation and complication rate to that in SC, with shorter procedural times in pediatric patients.

Keyword

Vascular access devices; Catheters; Indwelling; Pediatrics

MeSH Terms

Adult
Anti-Bacterial Agents
Catheters
Drug Therapy
Follow-Up Studies
Humans
Jugular Veins
Methods
Parenteral Nutrition
Pediatrics
Punctures*
Retrospective Studies
Ultrasonography
Vascular Access Devices
Anti-Bacterial Agents