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Endovascular Port-a-cath Insertion in a Patient With Cystic Fibrosis and Occluded Superior Vena Cava

Department of Vascular Surgery, King's College Hospital, Denmark Hill, London, United Kingdom

Hany Zayed, MD, MRCS

Department of Vascular Surgery, King's College Hospital, Denmark Hill, London, United Kingdom

Jason Wilkins, FRCR

Department of Radiology, King's College Hospital, Denmark Hill, London, United Kingdom

Hilary Wyatt, MRCP

Department of Paediatrics, King's College Hospital, Denmark Hill, London, United Kingdom

Hisham Rashid, MSc, FRCS

Department of Vascular Surgery, King's College Hospital, Denmark Hill, London, United Kingdom, hisham.rashid{at}kch.nhs.uk

Introduction: Port-a-cath insertion, for long-term intravenous antibiotic therapy, is an ideal solution for patient with cystic fibrosis. However, indwelling lines are liable to many complications including catheter thrombosis especially in patients having cystic fibrosis with hypercoagulable state. Methods: An endovascular technique for insertion of a port-a-cath in a patient having cystic fibrosis with occluded superior vena cava is reported. The technique is described in detail. In addition, a review of literature for the various methods of saving a failed central venous access in these patients was performed. Results: The line was successfully inserted and remained patent without need of any further intervention for 20 months. Conclusion: In this report, several endovascular skills were used for central venous access salvage that can be used in similar situations with chronic superior vena cava occlusion, which may not be suitable for thrombolysis or stenting.

Key Words: cystic fibrosis • port-a-cath • superior vena cava occlusion • endovascular treatment

This version was published on June 1, 2009

Vascular and Endovascular Surgery, Vol. 43, No. 3, 280-283 (2009)
DOI: 10.1177/1538574408329270


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