Lower Extremity Vascular Access in Neonates and Infants: A Single Institutional Experience

J Vasc Interv Radiol. 2015 Nov;26(11):1660-8. doi: 10.1016/j.jvir.2015.08.004.

Abstract

Purpose: To demonstrate feasibility and evaluate outcomes of direct-stick saphenous and single-incision tunneled femoral noncuffed central venous catheters (CVCs) placed in a large series of neonates and infants at a single institution.

Materials and methods: A retrospective review was performed for all neonates and infants receiving a lower extremity CVC by interventional radiology between 2007 and 2012. Technical success, mechanical and infectious complications, and catheter outcomes were recorded.

Results: There were 271 primary insertions performed in 243 children by interventional radiologists in the interventional radiology suite or at the bedside. CVCs were placed via the femoral vein with single-incision technique (84.9%) or the saphenous vein via a direct-stick technique (15.1%), with a technical success rate of 100%. The total number of catheter-days was 7,917 days (median, 19 d; range, 0-220 d). The number of primary catheter-days was 5,333 days (median, 15 d; range, 0-123.0 d), and salvage procedures prolonged catheter life by 2,584 days (median, 15 d; range, 1.0-101.0 d). The mechanical and adjusted infectious complication rates were 1.67 and 0.44 per 100 catheter-days.

Conclusions: Image-guided placement of saphenous or tunneled femoral catheters using a single incision is a safe and feasible method for vascular access in neonates and infants.

MeSH terms

  • Catheter-Related Infections / diagnostic imaging
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / prevention & control
  • Catheterization, Central Venous / statistics & numerical data*
  • Feasibility Studies
  • Femoral Vein / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Lower Extremity / blood supply
  • Lower Extremity / surgery
  • Philadelphia / epidemiology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Prevalence
  • Radiography, Interventional / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Saphenous Vein / surgery*
  • Treatment Outcome