Vessel Perforation and False Tracking Resulting From Umbilical Artery Catheterization

Abstract

We report an extremely low-birth-weight neonate who developed umbilical artery perforation and false tracking. There was no life-threatening event relating to the complication. Diagnosis was made at postmortem examination. Little information exists regarding the anatomic and vascular effects of umbilical artery catheterization placement in newborns. We report a new complication of umbilical artery catheterization. We raise the awareness regarding the potential life threat due to this rare but very serious complication.

Standard umbilical artery catheters used as diagnostic and neurointerventional guide catheters in the treatment of neonatal cerebrovascular malformations

“…However, umbilical catheterization is associated with potentially serious complications well documented in the neonatology literature, including aortic, iliac, and umbilical arterial perforation and dissection, aortic thrombosis, lower body thrombotic embolization, infection (including mycotic aneurysms), bladder rupture (due to the anatomic localization of the course of the umbilical arteries along the side of the bladder), and others 14–22. In order to lower the risk of these complications, potentially exacerbated by multiple days-long continuous indwelling of relatively large and stiff vascular sheaths, Sato et al published a case report describing a ‘retro-exchange technique’ in 2021, whereby the UAC was exchanged for a vascular sheath to allow embolization, after which the sheath was exchanged back to another UAC, and then the process repeated multiple times, so long as transumblical embolization was needed to alleviate cardiopulmonary failure 11.…”