Arterial misplacement of large-caliber cannulas during jugular vein catheterization: case for surgical management1

Shah, Pravin M.; Babu, Sateesh; Goyal, Arun; Mateo, Romeo B.; Madden, R.

doi:10.1016/j.jamcollsurg.2004.02.015

Cited by 95 publications

(80 citation statements)

References 25 publications

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“…Pulling large bore catheters and the application of pressure without angiographic or direct visualization is associated with major complications in 30 % to 47 % of patients. Compared to surgical exploration, catheter removal and artery repair is safer, and this approach is strongly recommended [9,10]. In a recent series of six patients, repair of carotid puncture sites with a suture-mediated closure device has also been shown to be safe and eff ective [11].…”

Section: Discussionmentioning

confidence: 99%

Central venous catheter misplaced in the vertebral artery

Pfammatter

Götschi

Puippe

2016

Vasa

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Section: Discussionmentioning

confidence: 99%

Central venous catheter misplaced in the vertebral artery

Pfammatter

Götschi

Puippe

2016

Vasa

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“…Excision and bypass is the mainstay of treatment for pseudo-aneurysms of the vertebral artery [8][9][10]. In fact, all reported pseudo-aneurysms secondary to central venous catheterization have been treated by open surgical repair.…”

Section: Discussionmentioning

confidence: 99%

Vertebral Artery Injury with Dialysis Catheter

Rana¹,

Oe²,

Iqbal³

et al. 2015

JCR

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Abstract:Vertebral artery pseudo-aneurysms and dissections are known to occur as a result of mechanical manipulations of the cervical region, traumatic injury, spontaneously and iatrogenic injury because of central venous catheterization. Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery injury (leading to pseudo-aneurysm and dissection) is one of the rarer complications of central venous catheter placement. We report a case of inadvertent vertebral artery catheterization during a dialysis catheter placement which subsequently demonstrated arterial blood. Duplex ultrasound and computed tomographic (CT) scan confirmed vertebral artery catheterization. It was successfully treated with open surgical technique by the vascular surgeon because of the size of catheter and subsequent requirement of artery repair. There were no neurological sequelae. Open surgical repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudo-aneurysms has been described with promising outcomes, but long-term results are lacking. This case report describes the rare iatrogenic event of vertebral artery injury and reviews its etiology, diagnosis, complications, and management.

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“…Cannulation of the carotid artery occurs less frequently, at a rate estimated as being between 0.0995% and 0.775%. 2 The literature supports the use of ultrasound (US) guidance for CVC via the internal jugular approach. Compared to landmark techniques, a reduction in the risk of carotid injury and cannulation has been demonstrated with the use of US, 3 We describe an intraoperative carotid artery puncture during attempted internal jugular venous cannulation, which occurred despite the use of US.…”

Section: To the Editormentioning

confidence: 99%

“…The traditional response has been removal of the needle or catheter and direct pressure at the site. 2,5 Is this ''cross your fingers'' approach appropriate? Reviews of management of carotid artery cannulation suggest surgical management is the safest and most effective treatment.…”

Section: To the Editormentioning

confidence: 99%

“…Clinically, one problem is the difficulty in precisely predicting the site of catheter entry into the artery by examining the skin entry site. 2 Local pressure to stop bleeding may not be effective and may result in complications. Surgical consultation may be suggested by these reviews, but there may be differences of opinion among surgeons regarding optimal management in these cases.…”

Section: To the Editormentioning

confidence: 99%

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