NEW APPROACHES FOR CATHETERIZATION AND VASCULAR ACCESS - THE TRANSHEPATIC TECHNIQUE

Thrombosis/obstruction of all of the conventional routes of central ve nous access is a potentially life-threatening problem in children with chronic disease. Patients who require diagnostic and interventional c ardiac catheterization procedures, chronic hemodialysis, chemotherapy and total parenteral nutrition are dependent upon central venous cathe ters, but may exhaust the usual sites of access over a relatively shor t period of time. Several authors have reported the use of a novel per cutaneous transhepatic technique to obtain central access for such chi ldren, when no other routes are available. This review examines the te chnique of obtaining central venous access using the transhepatic rout e, the indications for such an approach, the known experience to date, and several potential future applications. Copyright (C) 1996 Elsevie r Science Ireland Ltd.