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Jang, Jeon, Choo, Hwang, Kim, Lee, Nam, and Lim: Radiologically-Placed Venous Ports in Children Under Venous Anesthesia
Interventional Radiology

Journal of the Korean Society of Radiology 2015; 72(2): 101-107.

Published online: 3 February 2015

DOI: https://doi.org/10.3348/jksr.2015.72.2.101

Radiologically-Placed Venous Ports in Children Under Venous Anesthesia

Joo Yeon Jang, MD1, Ung Bae Jeon, MD1, Ki Seok Choo, MD1, Jae-Yeon Hwang, MD1, Yong-Woo Kim, MD1, Yun-Jin Lee, MD2, Sang Ook Nam, MD2, Young Tak Lim, MD2

1Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

2Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Corresponding author: Ung Bae Jeon, MD. Department of Radiology, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-up, Yangsan 626-770, Korea. Tel. 82-55-360-1840, Fax. 82-55-360-1848, junwb73@pnuyh.co.kr

Received 9 August 2014       Accepted 7 October 2014

Copyright © 2015 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Venous Port, Children, Intravenous Sedation

Figures and Tables

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.
jksr-72-101-g001
Table 1

Primary Disease of Patients

jksr-72-101-i001
Diagnosis No. of Patients (%)
Leukemia 11 (26.8)
Lymphoma 5 (12.1)
Hemophagocytic syndrome 4 (9.7)
Wilm's tumor 4 (9.7)
Epilepsy 3 (7.3)
Histiocytosis X 2 (4.9)
Immature teratoma 2 (4.9)
Hemophilia 1 (2.4)
Hypoxic ischemic encephalopathy 1
Intestinal pseudoobstruction 1
Neuroblastoma 1
Pleuropulmonary blastoma 1
Rhadomyosarcoma 1
Lissencephaly 1
Spinal muscular dystrophy 1
Ganglioneuroblastoma 1
Hepatoblastoma 1
Table 2

Venous Access for Port Insertion

jksr-72-101-i002
Venous Access No. of Ports
RIJV 42
RSCV 1
LSCV 1

Note.-LSCV = left subclavian vein, RIJV = right internal jugular vein, RSCV = right subclavian vein

Table 3

Types and Specifications of Ports Used

jksr-72-101-i003
Port Manufacturer Catheter Size (Fr) and Material Catheter Diameter (mm)* No. of Patients
Baby port B. Braun 4.5, polyurethane 1.5/0.8 29
Baxter Healthport Mini Max Baxter 6.5, silicone 2.0/1.0 9
Celsite ST 205 B. Braun 6.5, silicone 2.2/1.0 4
Vital-Port Petite Titanium Cook 6.5, silicone 2.2/1.0 2

Note.-*Diameters presented as outer diameter/inner diameter.

Table 4

Complication Cases

jksr-72-101-i004
Sex/Age Dx Duration (Days)* Cause of Removal Cause Organism
F/6 Hypoxic ischemic encephalopathy 105 Infection Pseudomonas
M/1 Intestinal pseudo-obstruction 10 Infection S. aureus
M/4 Lymphoma 110 Infection No growth
M/4 Lekemia 210 Pain
M/4 Lymphoma 156 Neutopenic fever
F/4 Hemophagocytic syndrome 177 Catheter kink

Note.-*Duration between port insertion and removal

Notes

This study was presented at AOCR 2012.

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