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- Slide 1: Made possible by Cincinnati Children's | Q&A | The Superior Vena Cava (SVC) is completely blocked. | Can you still place a central line? | YES / NO
- Slide 2: Made possible by Cincinnati Children's | YES / NO | Yes – and one option stands out: the Surfacer. | An image-guided way to recanalize the SVC from below — up through the femoral vein.
- Slide 3: Made possible by Cincinnati Children's | HOW IT WORKS | Up from the femoral, through the clot. | 1 Comes up the femoral vein (right side preferred — needs an open vein, or a remnant to cross) into the SVC clot. | 2 Bury the catheter at the exit site; draw a target 90° out. | 3 Line up the X-ray so the marker meets the planned exit; drive a needle out through the skin. | 4 Wire exits → through-and-through access → line placed.
- Slide 4: Made possible by Cincinnati Children's | Why it beats free-handing it: | Nathan Fagan, MD | Pediatric Interventional Radiologist, Akron Children's Hospital | And it suits acute pediatric cases — not the chronic scarring seen in adults.
- Slide 5: Made possible by Cincinnati Children's | THE NEXT FRONTIER | Steering the needle with sound — not radiation. | 4D intracardiac echo projects ultrasound in every direction. Reconstruct any plane, guide the needle across the occlusion — with less radiation. | Not in use yet — but the same principle applies
- Slide 6: Made possible by Cincinnati Children's | ⭐ The Takeaway | A completely blocked SVC no longer means no line. Image-guided recanalization can reopen a path that used to be a dead end. | Full video — link in bio. | GC
Can You Place a Central Line When the SVC Is Blocked?
Topic overview
Educational carousel addressing central venous catheter placement strategies when superior vena cava obstruction is present. Covers alternative access routes and technical considerations for pediatric patients requiring long-term venous access despite anatomic challenges.
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