Transverse Cervical Artery Pseudoaneurysm: A Rare Complication of Internal Jugular Vein Cannulation

Abstract

Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. Internal jugular vein catheterization is associated with a high rate of successful catheter placement. However, significant complications such as internal carotid artery (ICA) puncture, pneumothorax, vessel erosion, thrombosis, airway obstruction and infection can occur. The most common complication is ICA puncture. More recently a few cases of thyrocervical trunk pseudoaneurysm and fistula following internal jugular vein and subclavian vein catheterization attempts have been reported. Patients with renal failure who are on hemodialysis may have to undergo multiple catheter placements and vascular access interventions. This, along with their comorbid conditions, increases the risk of such complications. Here we report a patient on hemodialysis who developed transverse cervical artery pseudoaneurysm following an attempted right internal jugular vein catheterization. We report this case because of its rarity, to raise awareness of such a complication and to discuss different treatment options, in particular endovascular coil occlusion. A review of relevant literature is also presented.

Endovascular management of a posttraumatic pseudoaneurysm of the common carotid artery with superselective coil embolization

“…Common carotid artery pseudoaneurysm developing after central venous catheterization and resulting in cervical hematoma is a rare entity. 1 In this situation, an angiogram and embolization rather than surgery is the preferred mode of management both in terms of diagnosis and treatment. 2,3 Super-selective catheterization of the pseudoaneurysm and release of microcoils causes the sac to thrombose and allows control of bleeding.…”

Spontaneous Resolution of Delayed Onset Large Subclavian Artery Pseudoaneurysm -Case Report-

“…6) Delayed development of pulsating mass in the supraclavicular region is often associated with pseudoaneurysm of the thyrocervical trunk 16) or transverse cervical artery. 4) Arterial trauma caused by a large-bore dilator or catheter is usually associated with serious complications and requires prompt surgical or endovascular treatment. 6) Coil placement into a pseudoaneurysm in the acute phase can be dangerous because of the absence of a true aneurysm wall.…”

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

“…Treatment for a pseudoaneurysm used to rely on surgery, but in recent years, many new intervention radiological techniques like endovascular coil embolization, 6,7 balloon occlusion, intravascular injection of thrombin or N ‐butylcyanoacrylate have been developed with encouraging results. Coil embolization is considered relatively safe and can be performed even in patients with clotting abnormalities, undergoing anticoagulant or antiplatelet therapy 8 .…”