Endovascular Repair of an Inadvertent Right Vertebral Artery Rupture during Dialysis Catheter Insertion

Tasopoulou, Kalliopi-Maria; Argyriou, Christos; Mantatzis, Michael; Kantartzi, Konstantia; Passadakis, Ploumis; Georgiadis, George S.

doi:10.1016/j.avsg.2018.02.022

Cited by 4 publications

(7 citation statements)

References 27 publications

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“…This indicates a high risk of skipping the clot formed during blood flow resumption following catheter placement in the left vertebral artery and passing through the lesion [ Figures 4a and b ]. [ 6 ] To avoid this, occlusion of the distal left vertebral artery through the right vertebral artery was required [ Figure 4c ]. Second, the passage of the lesion under distal embolization would have prevented the complication of distal embolization [ Figure 4d ].…”

Section: Discussionmentioning

confidence: 99%

Removal of a central venous catheter penetrating the vertebral artery: A case report on endovascular treatment for blunt cerebrovascular injury

Kaneko¹,

Ikeda²,

Uezato³

et al. 2022

Surgical Neurology International

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Background: Anticoagulation and endovascular therapy are commonly used treatment methods for blunt cerebrovascular injury (BCVI). However, in certain cases, the perforating objects damaging the blood vessels need to be removed. In such cases, stenting and coil embolization have been reported to be useful. Furthermore, we believe that distal embolization can arrest bleeding at the perforation site when using such treatments. In support of this procedure, we report a case of successful BCVI treatment using distal embolization through contralateral side and proximal protection. Case Description: A 61-year-old man had an accidental placement of a central venous catheter that resulted in the perforation of the vertebral artery. Endovascular treatment was performed to remove the catheter and prevent bleeding during extraction. For this treatment, we used the method of distal embolization through the contralateral approach and proximal protection with a microballoon catheter followed by removal of the perforating catheter and additional embolization of the bleeding point under controlled blood flow. Conclusion: Under distal and proximal protections, we were able to successfully remove the perforating catheter without bleeding and ischemic complications. While treating BCVI, which requires the removal of perforating material, attention should be paid to the various protection methods and procedures.

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Section: Discussionmentioning

confidence: 99%

Removal of a central venous catheter penetrating the vertebral artery: A case report on endovascular treatment for blunt cerebrovascular injury

Kaneko¹,

Ikeda²,

Uezato³

et al. 2022

Surgical Neurology International

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“…Akkan et al described the option of manual compression under angiographic monitoring in a misplaced CVC in the VA that failed to achieve hemostasis, and resorted to stent grafting. In a separate case, the successful use of stent graft to seal the point of extravasation following inadvertent catheter insertion in the VA was reported, with an intact cerebral circulation on CTA; however, the patient died of septic shock due to an underlying infection during the post-op period [ 2 ]. Although embolization is considered as a second endovascular treatment option, successful coil embolization of the injured VA was reported in several cases with uneventful postprocedural neurological deficit, provided that the contralateral flow to the posterior circulation is sufficient [ 16 - 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several options for endovascular treatments were suggested such as tamponade by temporary balloon occlusion, stent grafting, vascular closure device, and occlusion by embolization [2,[15][16][17][18][19]. Akkan et al described the option of manual compression under angiographic monitoring in a misplaced CVC in the VA that failed to achieve hemostasis, and resorted to stent grafting.…”

Section: Discussionmentioning

confidence: 99%

“…Injury to the vertebral artery (VA) is not a common occurrence, but can occur during invasive procedures performed in the head and neck region; one of which being central venous catheter (CVC) insertion, with an incidence of <1% [ 1 ]. An early clinical suspicion and diagnosis can prompt immediate management and in turn avoid complications such as stroke, lacerations, dissection, hemorrhage, fistula formation, and rapidly growing pseudo-aneurysm leading to obstructive symptoms [ 2 - 3 ]. This type of injury is not commonly reported in the literature, hence the lack of treatment guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient

Rayes

Khattak

Qafani

et al. 2020

Cureus

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Vertebral artery (VA) injury during catheterization is quite rare given its anatomical position, but can be catastrophic when it is not discovered early on and managed accordingly. A multidisciplinary approach to the management of such injury has to weigh-in the benefits and risks of open surgery versus endovascular intervention. This can be done after thorough assessment of the patient’s condition and accessibility of the injured vessel. We report a case of a 90-year-old female admitted as a case of pneumonia associated with decreased level of consciousness. She acquired an iatrogenic injury due to insertion of central venous catheter (CVC) into her dominant right VA as confirmed via CT angiography (CTA). This case report aims to highlight the role of endovascular intervention in the acute management of VA injury in a critically ill patient.

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“…[1][2][3] The number of case reports in which acute-phase mispuncture required treatment is limited and there are no treatment guidelines. 4,5) We report a patient in whom an 8-Fr. sheath was misinserted into the right VA through the right IJV immediately before open heart surgery and endovascular therapy was performed immediately after mispuncture, leading to a favorable outcome.…”

Section: Introductionmentioning

confidence: 97%

Acute Endovascular Therapy for Iatrogenic Vertebral Artery Injury: A Case Report

Ito

Kojima

Yamanoi

et al. 2022

JNET

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Accidental puncture of the vertebral artery (VA) by central venous catheters and other devices has been reported as a rare complication. We performed endovascular therapy in the acute phase in a patient in whom a largecaliber sheath was misinserted into the VA.Case Presentation: A 68-year-old woman scheduled for open heart surgery had an 8-Fr. sheath inserted through the right internal jugular vein (IJV). This sheath penetrated the IJV and was misplaced in the V1 segment of the right VA.Endovascular therapy was performed. First, a 9-Fr. balloon-guiding catheter (BGC) was inserted and a 0.035-inch guidewire was pulled through it and the 8-Fr. sheath misinserted into the right VA. A 6-Fr. guiding catheter was inserted into the left VA and the microcatheter reached distal of where the sheath was inserted via the basilarunion. Then, the same area was embolized with coils to block retrograde blood flow. The BGC was then guided to the right VA origin using a pull-through wire while the 8-Fr. sheath was carefully withdrawn. The sheath was pulled back until just before exiting the VA and additional coils were placed via a microcatheter inserted into the BGC to occlude the right VA. Postoperatively, the patient had no neurological findings. Conclusion:We reported a rare case of iatrogenic VA injury. Attention to hemorrhage and intracranial blood flow resulted in a favorable outcome.

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Endovascular Repair of an Inadvertent Right Vertebral Artery Rupture during Dialysis Catheter Insertion

Cited by 4 publications

References 27 publications

Removal of a central venous catheter penetrating the vertebral artery: A case report on endovascular treatment for blunt cerebrovascular injury

Removal of a central venous catheter penetrating the vertebral artery: A case report on endovascular treatment for blunt cerebrovascular injury

Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient

Acute Endovascular Therapy for Iatrogenic Vertebral Artery Injury: A Case Report

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