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- Slide 1: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | Every central vein is blocked. Where does the line go? | When the chest is closed off, two last resorts remain.
- Slide 2: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | Two ways in when the chest is closed off. | Transhepatic | through the liver | Translumbar | through the back | Both reach the Inferior Vena Cava (IVC) directly, bypassing the blocked chest veins entirely.
- Slide 3: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | OPTION 1 — TRANSHEPATIC | Through the liver, into the IVC. | Transhepatic | through the liver | Both reach the Inferior Vena Cava (IVC) directly, bypassing the blocked chest veins entirely. | The tradeoff: more complicated, with a possible higher risk of thrombosis.
- Slide 4: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | OPTION 2 — TRANSLUMBAR | Through the back, into the IVC. | Translumbar | through the back | The IVC is accessed from behind. Locate it at the lumbar level with CT, guide the needle down, get access, place the line.
- Slide 5: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | So which one? | There's a real debate — but for pediatric patients, Dr. Nathan Fagan leans transhepatic. Control matters most when something goes wrong. | Nathan Fagan, MD | Pediatric Interventional Radiologist, Akron Children's Hospital
- Slide 6: Made possible by Cincinnati Children's | A PEDIATRIC IR CASE | ⭐ The Takeaway | When conventional access is gone, transhepatic and translumbar approaches remain — last resorts, but real options. | Full video — link in bio. | GC
Every Central Vein Is Blocked: Where Does the Line Go?
Topic overview
Educational carousel addressing alternative strategies for central venous catheter placement when conventional access sites are occluded. Reviews anatomical options and decision-making for complex vascular access scenarios in pediatric patients with limited venous options.
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