Radiologic placement of implantable chest ports in pediatric patients

OBJECTIVE. We evaluated the technical success and complications associated with radiologic placement of implantable chest ports in children For long-t erm central venous access. MATERIALS AND METHODS, Between May 1, 1996 and January 11, 2000, 29 chest p orts were placed in 28 children (15 girls, 13 boys: age range, 2-17 years, mean, 11.7 years), The patient's right internal jugular vein was used for a ccess in 93% (27/29) of the procedures, and a collateral neck vein was used as a conduit to recanalize the central veins in two procedures because of bilateral jugular and subclavian vein occlusion. All procedures were perfor med in interventional radiology suites. Both real-time sonography and fluor oscopy were used to guide venipuncture and port insertion. Follow-up data w ere obtained through the clinical examination and electronic review of char ts. RESULTS. Technical success was 100%. Fourteen percent of the catheters were removed prematurely, including one catheter removed 17 days after placemen t because the patient's blood cultures were positive for Candida albicans. No patients experienced hematoma, symptomatic air embolism. symptomatic cen tral venous thrombosis, catheter malposition. or pneumothorax. The median n umber of days for catheter use by patients was 280 days (total, 9043 days; range, 17-869 days). The rate of confirmed catheter-related infection was 1 4% or 0.04 per 100 venous access days. One catheter occluded after 132 days . CONCLUSION. In pediatric patients, radiologists can insert implantable ches t ports using real-time sonographic and fluoroscopic guidance with high rat es of technical success and low rates of complication.