Towbin R B, Ball W S
University of Cincinnati College of Medicine, Ohio.
Radiol Clin North Am. 1988 Mar;26(2):419-40.
In the last several years, we have witnessed a steady growth in both the number and the complexity of interventional procedures in the pediatric population. This article presents our approach to interventional techniques in children of different ages, specifying our methods of sedation, patient monitoring, and selection or modification of equipment. We present our experience with nonvascular and vascular intervention. In the nonvascular group, we have focused on genitourinary and gastrointestinal procedures, outlining the techniques we have found to be safe and effective. Percutaneous aspiration, drainage, and biopsy can be successfully accomplished in the majority of cases, even in the smallest child. Over this same period, the indications for vascular intervention have dramatically increased. Embolization has become an important asset for treatment of vascular malformations, management of hemorrhage, and medical renal ablation. In our institution, embolization is now the preferred method in many cases previously considered only amenable to surgery. Percutaneous transluminal angioplasty and the use of fibrinolytic therapy are considered effective in all age groups, but continue to have limited indications in the pediatric population. It is our hope that this experience will stimulate others to continue development of pediatric interventional techniques, thereby making them more widely available to children of all ages.
