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CC BY 4.0 · The Arab Journal of Interventional Radiology
DOI: 10.1055/s-0044-1787786
Original Article

Peripherally Inserted Central Venous Catheter (PICC) Line Use for Conjoined Twins: Single-Center Experience

Mohamed Elzahrani
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Yousof Al Zahrani
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Alwaleed Alqarni
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Meshal Alothri
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Mohammed Al Moaiqel
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Mohammed Alotaibi
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Amin Alzahrani
1   Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2   Department of Medical Imaging, Ministry of Health, Eastern Governance, Riyadh, Saudi Arabia
,
Abdulaziz Almulhim
3   King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Abstract

Purpose This article assesses the feasibility, safety, and efficacy of peripherally inserted central catheters (PICCs) in conjoined twins.

Material and Methods A retrospective chart review of all consecutive conjoined twins who had PICC placement at a tertiary center. Seventeen conjoined twins (12 females; 71%) had 25 PICC insertions. The average age of patients at PICC insertion was 15.9 ± 19.3 months. The most common type of twin was thoraco-omphalopagus (5 patients; 29%). The most common access was the brachial vein (N = 10, 40%). Thirteen procedures (52%) were performed before separation.

Results Seven long-term minor complications were identified (28%). The most common complication was malpositioning (8%). Average dwell time was 122 days while the average fluoroscopy time was 2 minutes and 3 seconds.

Conclusion Image-guided PICC placement in conjoined twins is safe and feasible. It provides excellent durable vascular access.

Keywords

interventional - peripherally inserted central catheter - thrombosis

Note

The study was presented as an oral presentation in PAIRS 2023.


Ethical Approval Statement

This study has obtained IRB approval from King Abdullah International Medical Research Center and the need for informed consent was waived.




Publication History

Article published online:
23 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Spitz L. Conjoined twins. Prenat Diagn 2005; 25 (09) 814-819
    CrossrefPubMedGoogle Scholar
  • 2 Sharma G, Mobin SS, Lypka M, Urata M. Heteropagus (parasitic) twins: a review. J Pediatr Surg 2010; 45 (12) 2454-2463
    CrossrefPubMedGoogle Scholar
  • 3 Mutchinick OM, Luna-Muñoz L, Amar E. et al. Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet 2011; 157C (04) 274-287
    CrossrefPubMedGoogle Scholar
  • 4 Edmonds LD, Layde PM. Conjoined twins in the United States, 1970-1977. Teratology 1982; 25 (03) 301-308
    CrossrefPubMedGoogle Scholar
  • 5 Conjoined twins - an epidemiological study based on 312 cases. Acta Genet Med Gemellol (Roma) 1991; 40 (3–4): 325-335
    PubMedGoogle Scholar
  • 6 Mian A, Gabra NI, Sharma T. et al. Conjoined twins: from conception to separation, a review. Clin Anat 2017; 30 (03) 385-396
    CrossrefPubMedGoogle Scholar
  • 7 Spitz L. Conjoined twins. Br J Surg 1996; 83 (08) 1028-1030
    CrossrefPubMedGoogle Scholar
  • 8 Winkler N, Kennedy A, Byrne J, Woodward P. The imaging spectrum of conjoined twins. Ultrasound Q 2008; 24 (04) 249-255
    CrossrefPubMedGoogle Scholar
  • 9 Aldulaigan E, Arabi M, Alharbi A, Alotaibi M. Peripherally inserted central catheter insertion in conjoined thoraco-omphalopagus twins. J Vasc Interv Radiol 2017; 28 (09) 1233
    CrossrefPubMedGoogle Scholar
  • 10 Deepak C, Vandana S, Pradeep B, Nikhil K. Anesthetic management of separation of conjoint twins: challenges and limitations. Saudi J Anaesth 2019; 13 (02) 140-143
    CrossrefPubMedGoogle Scholar
  • 11 Sinha A, Saxena R, Pathak M, Rodha MS. Conjoined thoracopagus twins - our experience of successful separation. J Indian Assoc Pediatr Surg 2021; 26 (05) 354-357
    CrossrefPubMedGoogle Scholar
  • 12 Sato Y, Iura A, Kawamoto Y, Yamamoto S, Iritakenishi T, Fujino Y. Successful anesthetic management of separation surgery for pygopagus conjoined twins: a case report. JA Clin Rep 2021; 7 (01) 6
    CrossrefPubMedGoogle Scholar
  • 13 Bakal CW. Chapter 35: Central venous access. In: Vascular and Interventional Radiology Principles and Practice. New York: Thieme; 2002: 447-456
    Google Scholar
  • 14 Shin HS, Towbin AJ, Zhang B, Johnson ND, Goldstein SL. Venous thrombosis and stenosis after peripherally inserted central catheter placement in children. Pediatr Radiol 2017; 47 (12) 1670-1675
    CrossrefPubMedGoogle Scholar