Minimally Invasive Approach to Managing Brachiocephalic Trunk Cannulation Complicating Central Venous Catheterization: A Case Report

Abstract

Background Central venous catheterization, crucial for device insertion, monitoring, medication, and fluid resuscitation, commonly uses the subclavian, internal jugular, and femoral veins. Despite its general safety, complications like arterial puncture can be life-threatening, requiring rapid diagnosis and treatment. Case presentation A 74-year-old woman with a cerebral infarction underwent right subclavian vein catheterization. The catheter was mistakenly placed in the brachiocephalic trunk, with its tip in the ascending aorta, as confirmed by computed tomography and digital subtraction angiography. Due to high surgical risks, catheter replacement was chosen instead of surgery or endovascular treatment. One month after the initial placement, the catheter was replaced with a smaller one, and another month later, it was removed without complications. Follow-up scans showed no leakage, and the patient’s vitals remained stable. Three months later, no abnormalities were observed. Conclusion This case demonstrates the effective use of a catheter replacement technique as a minimally invasive repair method when other options are impractical. Ultrasound guidance is also recommended to improve the procedure's accuracy and safety.