Haemodialysis catheter‐related right transverse cervical artery pseudoaneurysm and treatment by coil embolization

Abstract

In patients with end-stage renal disease, temporary placement of venous catheters for haemodialysis (HD) is often necessary, and the right internal jugular (RIJ) vein is the usual preferred site of HD catheter placement. We report here a patient who experienced complications because of the development of a pseudoaneurysm of the transverse cervical artery following an apparently uneventful RIJ vein cannulation for temporary HD, using the blind landmark-guided technique. This is a rare complication of RIJ vein cannulation and HD catheter placement. The pseudoaneurysm presented 3 weeks after the procedure and was diagnosed by using colour-Doppler ultrasound, followed by an angiogram, and it was successfully occluded using endovascular coil embolization.

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

“…A pseudoaneurysm may cause symptoms as bruit, pain, airway obstruction with pressure effects on local structures or may present with rupture, persistent hemorrhage, hematomas, embolisms or thrombosis [2,8,9] . The appearance of a pulsating mass with or without a bruit around the neck, shortly or even one to four weeks after the central venous cannulation of the IJV or SCV should raise the suspicion of a pseudoaneurysm [1,15] . In our patient, it occured immediately in to next morning after the IJV cannulation.…”

“…The pseudoaneurysm of our case was occluded using 5 coils and there has been no sign of recurrence within postoperative 2 months by now. Most reported cases with pseudoaneurysms measuring ≤ 4 cm in diameter were managed with non-surgical approaches, either using coil embolization or thrombin injections [1] .…”

“…Central venous cannulations are commonly used for different reasons such as hemodynamic monitoring, administration of drugs and blood products, hemodialysis, temporary cardiac pacemaker implantation, and in cases with no way of opening a peripheral venous access. However, more than 15% of patients may have complications such as arterial puncture, severe bleeding, hematoma, thrombosis, hemothorax, pneumothorax, airway obstruction, air embolism, atrial or ventricular arrhythmias, malpositioning of the catheter, intra-arterial placement of the catheter and secondary infections [1][2][3][4][5] . Thyrocervical trunk pseudoaneurysm, following internal jugular vein (IJV) cannulation attempts, is a rare complication and a few cases have been reported so far [1,2,[6][7][8][9] .…”