Major complications of percutaneous subclavian vein catheters

Feliciano, David V.; Mattox, Kenneth L.; Graham, Joseph M.; Beall, Arthur C.; Jordan, George L.

doi:10.1016/0002-9610(79)90313-1

Cited by 123 publications

(18 citation statements)

References 48 publications

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“…Their real frequency is like-ly to be underestimated, because most of them remain asymptomatic and finally heal spontaneously. In a study dealing with 1,500 subclavian venous catheterizations, FELICIANO et al [11] did not describe any cases of AVF. Among the 13,800 cases of subclavian venous catheterizations reported by EEROLA et al [12], there were 113 (0.9%) accidental arterial punctures, but there was no case of an AVF.…”

Section: Discussionmentioning

confidence: 96%

An opacity in the chest following a subclavian catheterization

Portel

Hilbert²,

Gruson³

et al. 1998

Eur Respir J

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A 70 yr old male was admitted to a nephrology department with an acute anuric renal failure. In his past history, one could note a hypertensive cardiomyopathy with an atrial fibrillation, treated with amiodarone, digoxine, flecainide, trinitrine and fluindione, and a noninsulin dependent diabetes treated with metformine. One month before admission, the patient had been treated for an ischaemic cerebrovascular stroke, which was complicated by a rhabdomyolysis responsible for renal failure with a creatinine clearance measured at 26 mL·min -1 .On admission, clinical examination revealed an overall cardiac failure and fine crackles were heard over the pulmonary bases. Oedema of the lower limbs was also found. Biological analysis revealed a worsening of the pre-existing renal failure with a creatinine clearance of 9 mL·min -1 without any associated ionic disorder. Diuretic treatment was initiated, enabling a transitory improvement before a rapid deterioration of the renal function occurred. The patient developed anuria, so that dialysis became necessary. The anticoagulant treatment was interrupted and treatment with heparin injections (250 IU·kg -1 ·day -1 in three injections) was initiated, 4 days before a dialysis catheter was set up. Injections immediately before and immediately after the venous catheterization were omitted. The prothrombin time was then measured at 96% and the activated

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Section: Discussionmentioning

confidence: 96%

An opacity in the chest following a subclavian catheterization

Portel

Hilbert²,

Gruson³

et al. 1998

Eur Respir J

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“…Although usually uncomplicated, this process can result in bleeding, pneumothorax, and hemothorax 2. Rarely, subclavian venipuncture results in an arteriovenous fistula (AVF), which can be potentially life‐threatening.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic subclavian arteriovenous fistula during permanent pacemaker implantation: Closed by endovascular coiling

Bera

Dharia

Trivedi

et al. 2018

Journal of Arrhythmia

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Iatrogenic arteriovenous fistula is a unique complication during pacemaker implantation. A 55‐year‐old man was posted for pacemaker implantation for recurrent unexplained syncope with trifascicular AV block. After axillary/subclavian venous puncture and introduction of RV lead, arterial spurting was immediately noticed as the the sheath was peeled away. After dissecting the overlying pectoralis muscle, deep sutures and manual compression achieved hemostasis. However, Subclavian arteriogram revealed an arteriovenous fistula from a lateral thoracic artery branch to the innominate vein. Hilal coils were deployed near the fistulous orifice, leading to complete resolution of the leak. After 3 days, pacemaker was implanted from right side. A multidisciplinary approach was the key to successful outcome.

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“…Travma hastalarında, anatomik yapılarda travmaya bağlı meydana gelen değişiklikler, kanama, volüm kaybı gibi nedenlerle SVK komplikasyonu görülme sıklığı yüksektir (8)(9)(10). Travma varlığında periferik venler hızla ulaşılabilmesi ve sıvı tedavisine erken başlanabilmesi gibi nedenlerle ilk önerilen vasküler yol olmakla birlikte, SVK endikasyonu her zaman bulunmaktadır (11).…”

Section: Introductionunclassified

Serious Complication of Central Venous Catheterization Due to Hemothorax: Hemothorax

Gaygısız¹,

Boyaci²,

Hoşgören³

et al. 2017

tybd

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ÖZ Santral ven kateterizasyonu işlemi hemotoraks ve pnömotoraks ve gibi ciddi komplikasyonlara yol açabilir. Bu olgu sunumunda çoklu travma ve hemotoraks nedeniyle yoğun bakımda izlenen bir hastada subklavian ven kateterizasyonu komplikasyonları olarak; ilk girişimde kılavuz tel ucunun koparak subkutan doku içinde kalması, ikinci girişimde damar içinden damar dışına geçerek hemotoraks içinde sonlanan kateterin neden olduğu hemotoraks sunulmuştur. Kırk yedi yaşında erkek hastada, sol subklavian kateterizasyon için ilk denemede kılavuz telin kolay ilerlemediği görülerek geri çekildi. İkinci kez yeni bir kateterle işlem tekrarlandı ve herhangi bir zorlukla karşılaşılmadan kateter yerleştirildi. Kateter yerinin doğrulanması için kateter içinden alınan örnekte çalışılan kan gazı venöz nitelikteydi. İşlem sonrası hastanın izleminde aynı taraftaki mevcut toraks tüpünden 500 mL hemorajik sıvı geldiği gözlendi. Çekilen kontrol akciğer grafisinde kateterin sol hemitoraks içinde olduğu, ayrıca sol klavikula altında kılavuz tele ait bir parçanın yer aldığı görüldü. Toraks bilgisayarlı tomografisinde kateterin sol subklavian bölgeden sol paramediastinal alana doğru uzandığı belirlendi. Subkutan doku içindeki kılavuz tel parçası ve damar içinden damar dışına geçerek ilerlemiş kateter acil cerrahi girişim uygulanarak çıkarıldı. Santral ven kateterinin ven içinde olduğunu kontrol etmek için yaygın olarak kullanılan yöntem, kolayca enjektöre çekilebilen kanın venöz nitelikte olduğunun belirlenmesidir. Ancak bu yöntem, aynı tarafta daha önceden hemotoraksı olan hastalarda kateterin damar içinde olduğunu kanıtlamakta yetersiz kalmaktadır. Anahtar Kelimeler: Santral venöz kateterizasyon, hemotoraks, travma, komplikasyon ABSTRACT Central venous catheterization may cause life-threatening complications including pneumothorax and hemothorax. We report a case of multiple trauma complicated with an incidence of hemothorax due to a misplaced central venous catheter. Firstly, the tip of the guidewire was ruptured in subcutaneous tissue and, secondly, the catheter came out of the vessel and caused hemothorax. During left subclavian catheterization, in this 47-years-old male patient, we could not advance the guide wire forward easily in the first attempt and tried to draw it back. In the second attempt, we inserted a new catheter without any difficulty. The blood gas analyses through the catheter for verification of location revealed its venous nature. After the catheterization, 500 mL hemorrhagic fluid was drained through the ipsilateral chest tube. Control chest X-ray showed that the catheter was in the left hemithorax and a piece of the guide wire was present below the left clavicle. Thorax computerized tomography showed that the catheter entered the thoracic cavity and extended to the paramediastinal region. An emergency surgery was performed to remove the piece of the guide wire and the catheter extending out of the vessel. A common method to check the intravenous insertion of a central catheter into a vein is to verify that the easily ...

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Major complications of percutaneous subclavian vein catheters

Cited by 123 publications

References 48 publications

An opacity in the chest following a subclavian catheterization

An opacity in the chest following a subclavian catheterization

Iatrogenic subclavian arteriovenous fistula during permanent pacemaker implantation: Closed by endovascular coiling

Serious Complication of Central Venous Catheterization Due to Hemothorax: Hemothorax

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