Highlights
- •Approximately one quarter of the pediatric vascular access encounters over the last decade were performed by IR, with a slight increase (3.8%).
- •Regionally, IR-provided access was greatest in the Midwest (33.5%), compared with the Northeast (23.4%), the South (22.7%), and the West (17.1%).
- •There was, however, a decrease in IR-performed procedures by 5.9% in the Midwest and an increase in the remaining three regions.
- •IR-placed pediatric vascular access has slightly increased over the last decade without significant service-line transfer to other specialties.
Abstract
Purpose
To evaluate central venous access placement trends for radiology and non-radiology
services over the last decade.
Materials and methods
Children who had central venous access procedures included in a large administrative
database of 49 pediatric institutions in the United States between 2010 and 2020 were
included. Patient demographics and patient specific factors were compared between
groups. The percentage of procedures performed by interventional radiology (IR) and
non-radiology services were compared over time and by region.
Results
A total of 483,181 vascular access encounters were recorded (45.3% female; median
age 2 years (IQR 0–11 years)). Approximately one quarter of vascular access encounters
were IR-led, with a slight increase of 3.8% between 2010 and 2020. Children who underwent
IR-placed vascular access were older (median age of 4 years compared to 1 year in
non-radiology encounters). Interventional radiology-placed access was greatest in
the Midwest (33.5%) with a decrease of 5.9% over the study period; in the other three
regions, IR-performed encounters increased. Patient comorbidities more prevalent in
the IR encounters were technology dependence (42.4% of all radiology encounters),
gastrointestinal (34.9%), respiratory (20.8%), and transplant (8.1%), while those
which were more prevalent in the non-radiology encounters were nephrology/urology
(21.4% of all non-radiology encounters), prematurity/neonatal (17.3%), and malignancy
(17.3%).
Conclusions
Interventional radiology-provided vascular access services have slightly increased
over the last decade without significant service-line transfer to other specialties.
Underlying comorbidities in IR-led vascular access encounters vary across institutions
based on referral patterns, possibly reflecting the adoption of ultrasound guidance
by other pediatric subspecialties.
Keywords
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Article info
Publication history
Published online: February 09, 2023
Accepted:
February 7,
2023
Received in revised form:
January 23,
2023
Received:
October 14,
2022
Identification
Copyright
© 2023 Published by Elsevier Inc.
