Main Logo
Logo

Society for Pediatric Radiology – Poster Archive

  139
  0
  0
 
 


Final ID: Paper #: 120

Peripherally inserted central catheters (PICCs) in Neonates: is there real thrombus?

Purpose or Case Report: Neonates with prolonged hospitalization often require PICCs. The concern for PICC-related complications, including venous thrombosis, infection, catheter migration and breakage, often prompts Doppler ultrasound (US) evaluation. However, peri-catheter thrombus in a neonate can be challenging to evaluate, as the accessed peripheral veins in neonates are small, some less than 1mm in luminal diameter. Small-bore catheters may occupy the entirety of the vessel lumen, which can produce absence of peri-catheter flow, which is confounding for thrombus. This distinction has implications for hematologic management.
Methods & Materials: IRB-approved A retrospective review of 644 extremity US studies for a PICC-related indication in 374 NICU infants and neonates (Sept 2009-Sept 2019). Reports were evaluated for descriptions of peri-catheter flow and frequency in venous thrombosis by categorizing findings into negative, occlusive or non-occlusive thrombosis, and indeterminate (reported as no definite thrombus, thrombus not excluded, or were purely descriptive). Catheter occupation of a vessel was identified by qualitative description of absent peri-catheter flow with catheter filling or occupying the vessel lumen. Chart review for patient demographics, underlying diagnosis, and initiation of anticoagulation was performed.
Results: The patient median age was 1.3 months (IQR 0.6-3.2 months), 44% female. An US diagnosis of thrombosis was reported in 52% (341/644) of studies performed for 109 patients (29% of total patients receiving an US). Catheter occupation was described in 16% (102/644) of studies for 83 patients, where 21% were reported negative for thrombus, 33% positive for thrombosis, and 46% indeterminate. Among studies reporting the catheter filling the vein, most with an indeterminate US did not receive anticoagulation (80%, 36/45). Alternatively, catheter occupation studies with a positive US finding for thrombosis were anticoagulated (74%, 20/27).
Conclusions: Absent pericatheter flow related to the catheter filling the vessel lumen is interpreted variably for thrombosis. Those reported positive for thrombosis often received anticoagulation, while those reported indeterminate were often not anticoagulated. Consensus on complete catheter occupation of a vessel lumen as it relates to thrombosis is important as it has implications on hematologic management of neonates. Further investigation of the normal progression of occlusive catheters is warranted in this population.
  • Durand, Rachelle  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Acord, Michael  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Srinivasan, Abhay  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Krishnamurthy, Ganesh  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Saade-lemus, Sandra  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Cahill, Anne Marie  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
  • Kaplan, Summer  ( Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , United States )
Session Info:

Scientific Session V-A: Fetal/Neonatal

Fetal Imaging / Neonatal

SPR Scientific Papers

More abstracts on this topic:
Caudothalamic Lesions in the Term Newborn: Think Twice!

Hurteau-miller Julie, Bilal Ahmed, Brophy Jason

Intracranial imaging findings in late Hemorrhagic Disease of Newborn

Yadav Vikas, Ealai Parthasarathy

More abstracts from these authors:
Application of Contrast-enhanced Ultrasonography and Shear Wave Elastography for Evaluation of Thyroid Nodules with Biopsy Correlation: Early Experience in Children

Smitthimedhin Anilawan, Krishnamurthy Ganesh, Sridharan Anush, Poznick Laura, Durand Rachelle, Whitaker Jayme, Escobar Fernando, Bauer Andrew, Cahill Anne Marie

Validation of CT Angiogram (CTA) in Assessment of Pediatric Renal Vascular Hypertension: A Comparison with Digital Subtraction Angiography

Smitthimedhin Anilawan, Otero Hansel, Cahill Anne Marie, Durand Rachelle

Preview
Paper____120.pdf
You have to be authorized to contact abstract author. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.

Not Available

Comments

We encourage you to join the discussion by posting your comments and questions below.

Presenters will be notified of your post so that they can respond as appropriate.

This discussion platform is provided to foster engagement, and stimulate conversation and knowledge sharing.

Please click here to review the full terms and conditions for engaging in the discussion, including refraining from product promotion and non-constructive feedback.

 

You have to be authorized to post a comment. Please, Login or Signup.

Please note that this is a separate login, not connected with your credentials used for the SPR main website.


   Rate this abstract  (Maximum characters: 500)