Stroke following central venous cannulation

Mainland, Phoebe; Tam, Wing Hung; Law, Bonita Ka Bo; Kee, Warwick Ngan

doi:10.1016/s0140-6736(97)24013-4

Cited by 30 publications

(22 citation statements)

References 5 publications

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“…5 These complications include hematoma, which can potentially expand and obstruct the airway, 6 hemothorax, 7,8 pseudoaneurysm, 8 arteriovenous fistula 9 (Fig 2), and stroke. 5,[10][11][12][13] No definite guidelines are found in the literature to address accidental large-bore (Ն7F) arterial cannulation in perioperative patients. These arterial traumas are managed either by removal and external compression, an endovascular intervention, or by surgical exploration and direct arterial repair.…”

mentioning

confidence: 99%

Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm

Guilbert

Elkouri

Bracco

et al. 2008

Journal of Vascular Surgery

252

279

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During central venous placement, prevention of arterial puncture and cannulation is essential to minimize serious sequelae. If arterial trauma with a large-caliber catheter occurs, prompt surgical or endovascular treatment seems to be the safest approach. The pull/pressure technique is associated with a significant risk of hematoma, airway obstruction, stroke, and false aneurysm. Endovascular treatment appears to be safe for the management of arterial injuries that are difficult to expose surgically, such as those below or behind the clavicle. After arterial repair, prompt neurological evaluation should be performed, even if it requires postponing elective intervention. Imaging is suggested to exclude arterial complications, especially if arterial trauma site was not examined and repaired.

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mentioning

confidence: 99%

Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm

Guilbert

Elkouri

Bracco

et al. 2008

Journal of Vascular Surgery

252

279

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“…In this area, surrounding tissues may not limit the formation of a large hematoma-such as was seen in the case reported by Jeganath et al These arteries should not be violently compressed externally. Mainland et al [4] have reported a case of stroke following central venous cannulation. In this case, an arteriovenous fistula was seen, but excessive external pressure may have contributed to the formation of a large thrombus intraarterially.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, the complications are divided into early and late categories. Early complications include pneumothorax and chylothorax [2], injury of carotid or subclavian arteries or even aortic arch [3], arteriovenous fistula [4], ventricular perforation [5], pericardial tamponade [6], air embolization, blindness [7], stroke and arrhythmias. Late complications include infection, thrombosis, pericardial effusion, and late mediastinal hemorrhage due to erosion of the vessels [8].…”

Section: Introductionmentioning

confidence: 99%

Severe vascular complications of central venous line placement

et al. 2011

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“…Despite the fact that the use of VCDs in extrafemoral arteries is only anecdotally reported, there are few small retrospective series suggesting that VCDs are probably the best way to handle such a complication [13][14][15], thus avoiding the potentially dangerous ''pull and compress'' technique, which is associated with an increased morbidity and mortality rate [5].…”

Section: Discussionmentioning

confidence: 99%

“…However, the inadvertent insertion of a CVC in a cervicothoracic artery may have serious consequences. Immediate catheter retrieval and manual compression may result in major complications such as false aneurysm, stroke, massive bleeding, and death [5][6][7]. In addition, some locations like the subclavian artery are not accessible to manual compression.…”

Section: Introductionmentioning

confidence: 99%

Erroneous placement of central venous catheter in the subclavian artery: Retrieval and successful hemostasis with a femoral closure device

Schütz

Doll

Bonvini

2010

Cathet Cardio Intervent

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Central venous catheter (CVC) placement, even if performed under duplex scan control, may be associated with incidental arterial injury leading to increased morbidity, mortality, and prolonged hospital stay. Erroneous CVC placement in the carotid or subclavian arteries has been usually treated surgically because those puncture sites may not be efficaciously compressed manually. However, surgery in this setting may be challenging because of difficulty of access for the catheters positioned in the subclavian artery and of the risk of cerebrovascular complications for carotid catheters. Recently, several cases have been published, describing the successful endovascular management of iatrogenic arterial injury using different types of vascular closure devices (VCD). However, in this setting, it remains difficult to be completely sure that the VCD has achieved complete hemostasis and that the patient does not subsequently incur in a clinically silent intrathoracic bleeding. We report the case of an erroneous CVC placement in the right subclavian artery successfully retrieved using an Angioseal VCD. The immediate and complete hemostasis at the puncture site was confirmed at angiography.

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Stroke following central venous cannulation

Cited by 30 publications

References 5 publications

Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm

Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm

Severe vascular complications of central venous line placement

Erroneous placement of central venous catheter in the subclavian artery: Retrieval and successful hemostasis with a femoral closure device

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