Application of DSA guidance in pediatric patients with difficult PICC catheterization

doi:10.3877/cma.j.issn.2095-5782.2021.04.018

Abstract

Abstract:

Objective

To summarize the experience of 6 pediatric patients with PICC catheterization difficulties under DSA guidance.

Methods

The data of 6 pediatric patients with catheterization difficulties during the insertion of PICC in our hospital from November 2017 to November 2019 were retrospectively analyzed, and the application methods of DSA devices in the pediatric PICC catheterization difficulties were summarized.

Results

Among the 6 cases of pediatric patients with PICC catheterization difficulties, 5 of which were successfully catheterized under DSA guidance. and 1 case had difficulty in catheter pushing due to brachiocephalic vein cava occlusion by venography, which was replaced by lower extremity great saphenous vein puncture. There were no intraoperative complications or intermediate complications in 6 cases after 7 days follow-up.

Conclusions

For children with difficulties in PICC catheterization, choosing DSA devices to guide catheterization or performing venous angiography can correctly adjust the ectopic location of the PICC tip or clarify the causes, and solve the catheterization difficulties caused by different reasons.

Key words: Interventional, Single frame fluoroscopy, DSA, PICC, Pediatrics

Ting Liu, Lei Guo, Zhaofang Zhang, Qun Xu, Xiaoqun Zhao, Baoyan Liu. Application of DSA guidance in pediatric patients with difficult PICC catheterization[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(04): 447-451.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2021.04.018

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References 20

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序号	年龄（月）	体重（kg）	性别	主要诊断	导管型号	穿刺静脉	推送困难原因
病例1	14	11	男	横纹肌肉瘤	3F	左侧头静脉	腋静脉内反折2次、锁骨下静脉1次
病例2	35	12	女	肺母细胞瘤	3F	右侧贵要静脉	颈内静脉内打圈
病例3	9	10	女	神经母细胞瘤	3F	右侧贵要静脉	进入左侧头臂静脉多次
病例4	8	3.5	男	先天性巨结肠	3F	左侧股静脉	进入髂总静脉侧支
病例5	0.5	3.5	男	肠旋转不良	1.9F	右侧头静脉	进入锁骨下静脉小侧支
病例6	71	18	男	胸腔积液、乳糜胸	3F	右侧贵要静脉、左侧大隐静脉	头臂静脉闭塞

序号	年龄（月）	体重（kg）	性别	主要诊断	导管型号	穿刺静脉	推送困难原因
病例1	14	11	男	横纹肌肉瘤	3F	左侧头静脉	腋静脉内反折2次、锁骨下静脉1次
病例2	35	12	女	肺母细胞瘤	3F	右侧贵要静脉	颈内静脉内打圈
病例3	9	10	女	神经母细胞瘤	3F	右侧贵要静脉	进入左侧头臂静脉多次
病例4	8	3.5	男	先天性巨结肠	3F	左侧股静脉	进入髂总静脉侧支
病例5	0.5	3.5	男	肠旋转不良	1.9F	右侧头静脉	进入锁骨下静脉小侧支
病例6	71	18	男	胸腔积液、乳糜胸	3F	右侧贵要静脉、左侧大隐静脉	头臂静脉闭塞

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