A Rare Complication of Internal Juguler Vein Cannulation: Pseudoaneurysm of the Thyrocervical Trunk

Abstract

Central venous cannulations, especially through internal jugular and subclavian veins, are commonly used for different reasons and associated with a high rate of successful placement. However, more than 15% of the patients may have complications. Although it is rare, thyrocervical trunk pseudoaneurysm may be one of the complications that follows multiple catheterization attempts. In this report, we present a case of thyrocervical trunk pseudoaneurysm developed after a difficult internal jugular vein cannulation using a landmark-guided technique. Our aim is to emphasize this rare complication, the importance of using ultrasound-guided central venous cannulations, identifying pseudoaneurysm(s) and also the treatment with endovascular coil embolization.

Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization

“…Thyrocervical trunk pseudoaneurysm is a rare entity occurring in previous reports as a complication of central venous catheterization [1,[15][16][17][18][19][20][21][22][23]. The pathogenesis usually involves arterial intimal injury creating discontinuity in the arterial wall, thereby allowing blood into the false arterial lumen, giving rise to pseudoaneurysm formation [24][25][26].…”

“…This technique has been referred to as the "smash-and-grab technique" [2]. The Horner's syndrome and pulsatile mass resolved postoperatively for their patient using this approach [17]. Another case report, by Dwivedi et al, described a patient requiring a pacemaker who underwent multiple attempts at right internal jugular and subclavian venous cannulation, ultimately resulting in thyrocervical pseudoaneurysm formation.…”