Every Central Vein Is Blocked: Where Does the Line Go?
Carousel1 min read·Published Oct 2026

Every Central Vein Is Blocked: Where Does the Line Go?

Pediatric IR case title slide showing surgeon performing procedure with text about blocked central veins.
Diagram comparing transhepatic and translumbar approaches to access the IVC in pediatric interventional radiology.
Slide explaining transhepatic approach for pediatric IR case, accessing IVC through liver to bypass blocked veins.
Slide explaining translumbar IVC access approach through the back at lumbar level using CT guidance.
Blue slide highlighting alternative vascular access routes in pediatric interventional radiology cases.
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Carousel · Oct 2026 · 1 min read

In brief

In brief

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.

Written by the GCMD Library team from the carousel.

Slides

6 pages · click to turn to one

A clinical comparison chart displaying three treatment modalities in vertical columns with icons, percentage metrics, and outcome indicators. Each column uses distinct color coding and includes graphical representations of success rates, complication profiles, and patient ambulation outcomes. The layout emphasizes quantitative comparisons through bar charts and numerical data points.

Central venous access. A social-media carousel made possible by Cincinnati Children's.
The text in the image

Pediatric Achalasia: Surgical Approach Comparison | Heller Myotomy | 78% Success Rate | Esophageal Dilatation | 45% Success Rate | POEM (Per-Oral Endoscopic Myotomy) | 99% Success Rate | Complication Rates | Training Requirements | Ambulation Outcomes | 742 Cases Reviewed | Lines A and B: 71-83% Ambulation | Without Cells: 20% Ambulation | Neuroprotection Study | Ovine Model | Human Placental Mesenchymal Stromal Cells | In Utero Myelomeningocele Repair

The text on each 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.
  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.
  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.
  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.
  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
  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
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