1
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Palesy T, Neal J, Bhutia S. Iatrogenic injury to the subclavian artery during central venous access. J Vasc Access 2024; 25:1335-1337. [PMID: 37184122 DOI: 10.1177/11297298231174065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Subclavian artery injury during central venous line placement is a potentially life-threatening complication. Due to historically high mortality rates with attempted manual pressure for haemostasis, the current favoured method of repair is by open or endovascular means. This case describes the management of a central venous catheter placed through the internal jugular vein into the subclavian artery via a supraclavicular puncture. CT angiography revealed the arterial injury located 1 cm distal to the vertebral artery origin. Under fluoroscopic guidance in an endovascular hybrid theatre, a covered stent was deployed across the affected segment of the subclavian artery which resulted in occlusion of the vertebral artery origin to attain safe proximal seal. This was done during simultaneous removal of the catheter and manual pressure over the internal jugular vein. There were no complications and the patient recovered well post-procedure. This case highlights the importance of appropriate ultrasound techniques for central catheter insertion for precise visualisation to prevent inadvertent injury to distal structures. CT angiography is useful in planning endovascular management. Occlusion of the vertebral artery in this case did not result in any neurological complications.
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Affiliation(s)
- Tom Palesy
- Department of Vascular Surgery, Cairns Hospital, Cairns, QLD, Australia
| | - Joanna Neal
- Department of Vascular Surgery, Cairns Hospital, Cairns, QLD, Australia
| | - Sherab Bhutia
- Department of Vascular Surgery, Cairns Hospital, Cairns, QLD, Australia
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2
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Kania T, Kimyaghalam A, Scarsella J, Guerges M, Breier Y, Deitch J, Malekpour F, Schor J, Singh K. Supra-Aortic Arterial Injuries Following Central Venous Catheterization Managed with Percutaneous Closure Devices: A Comprehensive Literature Review of Current Evidence. Ann Vasc Surg 2023; 96:301-307. [PMID: 37169251 DOI: 10.1016/j.avsg.2023.04.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 04/02/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Inadvertent supra-aortic arterial injuries during central venous catheterization can lead to devastating outcomes. These have been traditionally been managed with open repair or covered stent placement; only recently have percutaneous closure been incorporated into the management of these iatrogenic arterial injuries. METHODS We performed a MEDLINE literature search in the English language, using the PubMed web-based search engine across years 2000 to 2020. This report reviews 34 published case reports and series reporting 71 iatrogenic supra-aortic arterial injuries managed with percutaneous vascular closure devices. RESULTS In our review, the use of a closure device was successful in 87% of cases, even in some cases involving sheath sizes greater than 8F. The devices used in these situations caused minimal complications and offered a quick means to control bleeding. Thus, percutaneous closure devices are a helpful tool that offers an alternative to more invasive open surgical repair. CONCLUSIONS Vascular closure devices offer a minimally invasive and effective approach to the treatment of inadvertent supra-aortic arterial injury following CVC.
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Affiliation(s)
- Thomas Kania
- Staten Island University Hospital, Staten Island, NY.
| | | | | | - Mina Guerges
- Staten Island University Hospital, Staten Island, NY
| | - Yuli Breier
- Touro College of Osteopathic Medicine, New York, NY
| | | | | | | | - Kuldeep Singh
- Staten Island University Hospital, Staten Island, NY
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3
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Kohyama T, Fujimaki K, Sasamori H, Tokumine J, Moriyama K, Yorozu T. Inadvertent catheter misplacement into the subclavian artery during ultrasound-guided internal jugular venous catheterization: a case report. JA Clin Rep 2023; 9:58. [PMID: 37672125 PMCID: PMC10482804 DOI: 10.1186/s40981-023-00649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Ultrasound-guided central venous catheterization has become a standard procedure. However, mechanical complications are still reported. CASE PRESENTATION An 85-year-old woman presented with coagulopathic bladder tamponade. Ultrasound-guided right internal jugular venous catheterization was planned because of difficult peripheral venous access. A guidewire was advanced through a needle inserted at the midpoint of the right carotid triangle. The guidewire was identified in the short axis, but not in the long-axis ultrasound view, leading to inadvertent insertion of the catheter into the right subclavian artery through the internal jugular vein. Stent graft insertion was performed for perforation closure. The patient exhibited no symptoms of cerebral ischemia following stent graft insertion. DISCUSSION This case demonstrated that the needle-sticking site should not be placed close to the clavicle for ultrasound-guided internal jugular venous catheterization, as it may not confirm the position of guidewire in the long-axis ultrasound view.
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Affiliation(s)
- Tomoki Kohyama
- Department of Anesthesia, National Hospital Organization Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014, Japan
| | - Keisuke Fujimaki
- Department of Cardiovascular Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroki Sasamori
- Department of Neurosurgery, Hayama Heart Center, 1898-1 Shimoyamaguchi, Hayama, Miura, Kanagawa, 240-0116, Japan
| | - Joho Tokumine
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Kiyoshi Moriyama
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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4
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Li L, Chen Y. Life-threatening airway obstruction due to retropharyngeal and cervicomediastinal hematomas following transjugular intrahepatic portosystemic shunt procedure for acute variceal bleeding in cirrhosis. Clin Case Rep 2023; 11:e7005. [PMID: 36911633 PMCID: PMC9992143 DOI: 10.1002/ccr3.7005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
We report a case of life-threatening airway obstruction due to retropharyngeal-cervicomediastinal hematomas following transjugular intrahepatic portosystemic shunt or acute variceal bleeding in cirrhosis. Even though this is a rare complication, clinicians should maintain a high index of suspicion and evaluate and treat it promptly to prevent a fatal outcome.
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Affiliation(s)
- Long Li
- Division of Interventional Radiology, Department of Medical ImagingGuangzhou Twelfth People's HospitalGuangzhouGuangdongChina
| | - Yong Chen
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina
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5
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Giagtzidis I, Soteriou A, Papadimitriou C, Papoutsis I, Karkos C. Use of a Closure Device for the Management of Inadvertent Placement of a Central Venous Catheter in the Carotid Artery: A Case Report and Literature Review. Cureus 2023; 15:e34911. [PMID: 36938245 PMCID: PMC10015422 DOI: 10.7759/cureus.34911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
The placement of a central venous catheter (CVC) is a common intervention in hospitalized patients. Several adverse events have been reported in this "blind" procedure when it is performed without the aid of ultrasound, including artery catheterization, which although uncommon, is a serious complication. Potential treatment options include manual compression, open surgical repair, and endovascular treatment. A 62-year-old critically ill patient with accidental arterial catheterization of the right common carotid artery (CCA) during placement of CVC is presented. The catheter was removed successfully with the use of a Perclose-ProGlide closure device. A systematic literature review was performed to identify similar cases treated with the same technique. This case presents an alternative minimally invasive treatment option, using a Perclose Proglide (Abbott) closure device for the removal of a misplaced CVC in the right CCA. Although this is an off-label use of the device it can be an effective alternative treatment option, especially in unstable patients.
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Affiliation(s)
- Ioakeim Giagtzidis
- 5th Surgical Department/Vascular Surgery, Hippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Andrea Soteriou
- 5th Surgical Department/Vascular Surgery, Hippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Christina Papadimitriou
- 5th Surgical Department/Vascular Surgery, Hippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Ioakeim Papoutsis
- 5th Surgical Department/Vascular Surgery, Hippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Christos Karkos
- 5th Surgical Department/Vascular Surgery, Hippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC
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6
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Ezeh E, Smith K, Perdoncin M, Gilbert B, Rueda C, Tackett E. ST-Segment Elevation Myocardial Infarction on the Line: Inadvertent Arterial Infusion of Vasopressors Causing Acute Myocardial Infarction. J Investig Med High Impact Case Rep 2023; 11:23247096221150729. [PMID: 36644900 PMCID: PMC9846586 DOI: 10.1177/23247096221150729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Central venous catheters (CVCs), regarded as lines of life, are helpful in hemodynamic monitoring and delivering medications to patients. However, there are several complications that can result from the placement of CVCs. This includes accidental arterial puncture, which has a temporal association with hemorrhage, hematoma, and stroke. Infusion of vasopressors through such a mispositioned arterial CVC further increases the risk of these complications with potential end-organ ischemia. Here, we discuss the case of a 76-year-old woman who developed a myocardial infarction, heart failure, and subarachnoid hemorrhage following the arterial infusion of vasopressors through a malpositioned CVC.
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Affiliation(s)
| | - Kyle Smith
- Joan C. Edwards School of Medicine, Huntington, WV, USA
| | | | | | - Carlos Rueda
- Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Eva Tackett
- Joan C. Edwards School of Medicine, Huntington, WV, USA
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7
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Discalzi A, Maglia C, Ciferri F, Mancini A, Gibello L, Calandri M, Varetto G, Fonio P. Percutaneous closure of accidentally subclavian artery catheterization: time to change first line approach? CVIR Endovasc 2022; 5:23. [PMID: 35612765 PMCID: PMC9133280 DOI: 10.1186/s42155-022-00300-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/29/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To present our experience and provide a literature review dissertation about the use of a suture-mediated percutaneous closure device (Perclose Proglide -PP- Abbott Vascular Inc., Santa Clara, CA, USA) to achieve hemostasis for unintended subclavian arterial catheterization during central venous line placement. MATERIALS & METHODS Since October 2020, we have successfully treated four consecutive patients with a central venous catheter (8 to 12 French) in the subclavian artery. In each patient, we released a PP, monitoring its efficacy by performing a subclavian angiogram and placing, as a rescue strategy, an 8 mm balloon catheter near the entry point of the misplaced catheter. Primary outcome is technical and clinical success. Technical success is defined as absence of bleeding signs at completion angiography, while clinical success is a composite endpoint defined as absence of hematoma, hemoglobin loss at 12 and 24 h, and absence of procedure-related reintervention (due to vessel stenosis, pseudoaneurysm or distal embolization). RESULTS Technical success was obtained in 75% of cases. In one patient a mild extravasation was resolved after 3 min of balloon catheter inflation. No early complications were observed for all patients. CONCLUSIONS PP showed a safe and effective therapeutic option in case of unintentional arterial cannulation. It can be considered as first-line strategy, as it does not preclude the possibility to use other endovascular approaches in case of vascular closure device failure.
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Affiliation(s)
- Andrea Discalzi
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy.
| | - Claudio Maglia
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy
| | - Fernanda Ciferri
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy
| | - Andrea Mancini
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy
| | - Lorenzo Gibello
- Department of Surgical Sciences, Division of Vascular Surgery, University of Torino, Turin, Italy
| | - Marco Calandri
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy
| | - Gianfranco Varetto
- Department of Surgical Sciences, Division of Vascular Surgery, University of Torino, Turin, Italy
| | - Paolo Fonio
- Department of Surgical Sciences Radiology unit, University of Torino, Via Genova 3, 10126, Turin, Italy
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8
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Kaneko R, Ikeda H, Uezato M, Chin M. Removal of a central venous catheter penetrating the vertebral artery: A case report on endovascular treatment for blunt cerebrovascular injury. Surg Neurol Int 2022; 13:84. [PMID: 35399886 PMCID: PMC8986647 DOI: 10.25259/sni_1203_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/07/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Anticoagulation and endovascular therapy are commonly used treatment methods for blunt cerebrovascular injury (BCVI). However, in certain cases, the perforating objects damaging the blood vessels need to be removed. In such cases, stenting and coil embolization have been reported to be useful. Furthermore, we believe that distal embolization can arrest bleeding at the perforation site when using such treatments. In support of this procedure, we report a case of successful BCVI treatment using distal embolization through contralateral side and proximal protection. Case Description: A 61-year-old man had an accidental placement of a central venous catheter that resulted in the perforation of the vertebral artery. Endovascular treatment was performed to remove the catheter and prevent bleeding during extraction. For this treatment, we used the method of distal embolization through the contralateral approach and proximal protection with a microballoon catheter followed by removal of the perforating catheter and additional embolization of the bleeding point under controlled blood flow. Conclusion: Under distal and proximal protections, we were able to successfully remove the perforating catheter without bleeding and ischemic complications. While treating BCVI, which requires the removal of perforating material, attention should be paid to the various protection methods and procedures.
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9
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Opperman PJ, Thompson JR, Surdell DL. Erroneous Central Venous Catheter Placement: Multidisciplinary Primary Surgical Repair of the Vertebral Artery. Cureus 2022; 14:e22933. [PMID: 35399454 PMCID: PMC8986343 DOI: 10.7759/cureus.22933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 11/07/2022] Open
Abstract
Central venous catheters are a common practice in critical care medicine. These lines are of particular importance when a patient needs large volume resuscitation or medications that cannot be infused through a peripheral line. Even though central venous catheters are frequently utilized, they are associated with potentially significant risks that one must be aware of when attempting placement. The anatomy and pertinent complications are key for any healthcare professional to be aware of during this procedure. As such, vascular injury has been described in the literature, but vertebral artery injury and common repair techniques are less common. Primary repair of the second vertebral artery segment is infrequently detailed in the literature and this report describes pertinent case details and plan of action for identification and repair of iatrogenic vertebral artery injury following catheter placement.
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10
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Nwokolo O, Liang Y. Avoiding inadvertent subclavian artery puncture during central venous catheter placement. J Clin Anesth 2021; 75:110428. [PMID: 34340109 DOI: 10.1016/j.jclinane.2021.110428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/02/2021] [Accepted: 06/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- OmoneleO Nwokolo
- Departments of Anesthesiology, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yafen Liang
- Departments of Anesthesiology, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, TX, USA.
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11
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Management of Inadvertent Supra-aortic Arterial Lesions During Central Venous Access Procedures: Report of Six Cases and Proposed Algorithm. Ann Vasc Surg 2021; 75:308-314. [PMID: 33819587 DOI: 10.1016/j.avsg.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/21/2022]
Abstract
Accidental supra-aortic arterial cannulation during central venous catheter (CVC) insertion is a rare and serious complication associated with risk of vascular and neurologic complications. The aim of this study is describing our 6 cases experience and propose a management algorithm. We retrospectively evaluated the diagnosis and treatment of six patients arrived at our Department for accidental supra-aortic arterial cannulation during CVC insertion. They underwent Doppler Ultrasonography (DUS) or Computed Tomography Angiography (CTA) to confirm the arterial damage and to decide the correct therapeutic pathway. Four patients underwent DUS as the shallow location of injured arteries and 2 patients CTA because of the arterial damage deeply located. Surgical procedure with direct arterial suture was performed in four patients. Endovascular treatment with stent graft deployment was carried out in two patients. All procedures were conducted successfully: technical success (immediate hemostasis and vessel patency) was obtained in 100% of the cases. Postoperative imaging (DUS or CTA) confirmed the absence of arterial bleeding and the arterial patency. No perioperative mortality or complications occurred. After a careful review of literature and our case series, we proposed an algorithm to delineate the optimal treatment strategy, explaining that early and careful diagnosis (by DUS or CTA) and prompt repair appear crucial to achieve good outcomes and clarifying that an endovascular technique (stent graft placement or vascular closure device) seems to be the best treatment in these cases. Finally, an open surgical technique could be indicated in case of common carotid artery injury and concurrent catheter passing through the target vein.
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12
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Kesman RA, Mehollin-Ray AR, Lantin-Hermoso R, Colquitt J, Fernandes CJ, Premkumar MH. When the course deviates from expected: Misplacement of an epicutaneo-caval catheter in a neonate. J Vasc Access 2021; 23:624-627. [PMID: 33706604 DOI: 10.1177/11297298211000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Central venous access, a common and essential component of the care of the critically ill neonate, is associated with complications such as infection, thrombosis, and bleeding. Unintentional arterial cannulation of a venous catheter is a rare but potentially dangerous complication. In the report, we describe the accidental cannulation of an artery with an epicutaneo-caval catheter in an extremely low birth weight infant. We discuss the physical and radiological findings that raise the suspicion of an arterial placement of a catheter, the diagnostic tools to confirm the misplacement, the potential complications, and strategies to prevent it.
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Affiliation(s)
- Russell A Kesman
- Division of Cardiac Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amy R Mehollin-Ray
- E. B. Singleton Department of Radiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Regina Lantin-Hermoso
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - John Colquitt
- Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Caraciolo J Fernandes
- Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Muralidhar H Premkumar
- Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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13
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(Percutaneous closure of iatrogenic injury of arteria). COR ET VASA 2020. [DOI: 10.33678/cor.2020.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Al Rayes A, Khattak Y, Qafani A, Anwar M, Al Sibaie A. Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient. Cureus 2020; 12:e9956. [PMID: 32850268 PMCID: PMC7444997 DOI: 10.7759/cureus.9956] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Vertebral artery (VA) injury during catheterization is quite rare given its anatomical position, but can be catastrophic when it is not discovered early on and managed accordingly. A multidisciplinary approach to the management of such injury has to weigh-in the benefits and risks of open surgery versus endovascular intervention. This can be done after thorough assessment of the patient's condition and accessibility of the injured vessel. We report a case of a 90-year-old female admitted as a case of pneumonia associated with decreased level of consciousness. She acquired an iatrogenic injury due to insertion of central venous catheter (CVC) into her dominant right VA as confirmed via CT angiography (CTA). This case report aims to highlight the role of endovascular intervention in the acute management of VA injury in a critically ill patient.
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15
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[Finger pain and personality changes after chemotherapy initiation via a central venous port system in a 67-year-old female patient]. Internist (Berl) 2020; 61:1055-1058. [PMID: 32757047 DOI: 10.1007/s00108-020-00848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Central venous port systems are an integral part of chemotherapy. Early recognition and management of arterial malposition are crucial to prevent further complications. A 67-year-old female with breast cancer underwent central venous port implantation for adjuvant chemotherapy. After administration of the first chemotherapy the patient developed acute bihemispheric cerebral infarction and myocardial ischemia due to arterio-arterial emboli with a toxic encephalopathic component. After systemic lysis and surgical removal of the central venous port system, the patient showed a complete recovery.
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16
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Endovascular Repair of a Common Carotid Artery Perforation during Pacemaker Insertion. Ann Vasc Surg 2020; 68:568.e11-568.e15. [PMID: 32283301 DOI: 10.1016/j.avsg.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND We report the percutaneous endovascular management of an iatrogenic perforation of the left common carotid artery (LCCA) during an attempted trans-subclavian pacemaker (PM) placement. METHODS An 87-year-old woman was urgently transferred after an attempted left subclavian vein PM implantation. Computed tomography angiography scan showed the accidental cannulation of LCCA in its most proximal segment. Owing to the significant surgical risks, the mortality rate, and the distal position of the vessel from the skin, we opted for an endovascular strategy with a balloon-expandable stent graft. The Advanta 8 × 38 mm V12 was inserted via a 7 French Flexor Introducer sheath through the right common femoral artery. RESULTS The patient was discharged on postoperative day 2 without complications. A 6-month follow-up computed tomography angiography demonstrated stent graft and LCCA patency and the patient was in a good stable condition. CONCLUSIONS This case highlights the effectiveness of a minimal invasive endovascular approach to treat this uncommon but potentially lethal injury.
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17
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Smolevitz J, Daab L, Liem T, Politano A. Hybrid Repair of an Iatrogenic Left Subclavian Artery Injury: A Case Report. Ann Vasc Surg 2020; 67:563.e7-563.e11. [PMID: 32234396 DOI: 10.1016/j.avsg.2020.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 10/24/2022]
Abstract
We present the case of an iatrogenic injury to the left subclavian artery during placement of a port for chemotherapy. The artery was inadvertently accessed at its infraclavicular position, and then was perforated centrally, entering the mediastinum at the origin of the left vertebral artery. Given that the patient's posterior circulation was largely dependent on the left vertebral artery, it could not be sacrificed. To preserve her left vertebral artery and to avoid the need for a sternotomy, which would more substantially delay initiation of chemotherapy, we elected to perform a hybrid repair: an open left carotid to vertebral artery bypass with reversed great saphenous vein followed by repair of the proximal left subclavian injury with a covered stent graft, which was delivered via the left axillary artery. The patient recovered uneventfully. This case demonstrates a hybrid open and endovascular repair for a complex iatrogenic arterial injury. We were able to obtain a desirable outcome by careful assessment of the anatomic particulars of her injury and the technical constraints in proposed methods of repair, all in the context of the patient's overall goals of care.
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Affiliation(s)
- Jill Smolevitz
- Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, OR.
| | - Leo Daab
- Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, OR
| | - Timothy Liem
- Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, OR
| | - Amani Politano
- Division of Vascular and Endovascular Surgery, Oregon Health & Science University, Portland, OR
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18
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Park S, Jeong B, Shin JH, Kim JH, Kim JW, Gwon DI, Ko GY, Chen CS. Interventional treatment of arterial injury during blind central venous catheterisation in the upper thorax: experience from two centres. Clin Radiol 2019; 75:158.e1-158.e7. [PMID: 31711638 DOI: 10.1016/j.crad.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/03/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the safety and clinical efficacy of interventional treatment for arterial injury during blind, central venous catheterisation in the upper thorax at two tertiary medical centres. MATERIALS AND METHODS Eighteen consecutive patients (37-81 years; M:F=8:10) who underwent interventional treatment for the arterial injuries that occurred during central venous catheterisation without any imaging guidance between November 2007 and December 2018 were included. Clinical data, angiographic findings, detailed interventional procedures, and technical and clinical outcomes were analysed retrospectively. RESULTS Arterial injury sites were the subclavian artery/branches (n=12), axillary artery/branches (n=2), and common carotid artery (n=4). The target vein was not correlated with the corresponding artery/branches in eight patients (44.4%); internal jugular vein to subclavian artery branches. Angiographic findings were pseudoaneurysm (66.7%, 12/18), contrast medium extravasation (22.2%, 4/18), or both (11.1%, n=2). A stent graft was inserted for the main trunk injuries in nine patients, with (n=2) or without (n=7) prior arterial branch embolisation to prevent potential endoleak, while embolisation for the arterial branch injuries was performed in nine patients. Direct percutaneous access with thrombin injection to the pseudoaneurysm or residual arteriovenous fistula was utilised in two. The technical and clinical success rate was 94.4% (17/18) each. There were no procedure-related complications. In one patient without immediate clinical success, there was a persistent pseudoaneurysm after stent graft placement, which was treated with in-stent balloon dilation. CONCLUSION Interventional treatment serves as a safe and effective treatment modality for inadvertent arterial injury related to blind, central venous access catheterisation in the upper thorax.
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Affiliation(s)
- S Park
- Department of Radiology, Gachon University Gil Medical Centre, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, South Korea
| | - B Jeong
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - J H Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
| | - J H Kim
- Department of Radiology, Gachon University Gil Medical Centre, 21, Namdong-daero 774beon-gil, Namdong-gu, Incheon, South Korea
| | - J W Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - D I Gwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - G-Y Ko
- Department of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - C S Chen
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, 1 Jianshe E Rd, Erqi Qu, Zhengzhou Shi, Henan Sheng, PR China
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19
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Shaw M, Chandrashekhara SH, Sharma A, Kumar S. Inadvertent arterial placement of central venous catheter: salvage using endovascular treatment. BMJ Case Rep 2019; 12:12/11/e231751. [PMID: 31704801 DOI: 10.1136/bcr-2019-231751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The frequency of placing a central venous catheter (CVC) has increased and it is often performed in emergency situation for venous access. During such an emergency and placing without imaging guidance, sometimes inadvertent placement of CVC in subclavian artery (SCA) can occur. We hereby describe an unusual case of successful endovascular management of inadvertently inserted CVC in SCA by covered stent graft placement along with proper clinical context to manage a case of misplaced venous catheter in left SCA.
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Affiliation(s)
- Manish Shaw
- CVR & EI, All India Institute of Medical Sciences, New Delhi, India
| | | | - Arun Sharma
- CVR & EI, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar
- CVR & EI, All India Institute of Medical Sciences, New Delhi, India
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20
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Dornbos DL, Nimjee SM, Smith TP. Inadvertent Arterial Placement of Central Venous Catheters: Systematic Review and Guidelines for Treatment. J Vasc Interv Radiol 2019; 30:1785-1794. [DOI: 10.1016/j.jvir.2019.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/24/2019] [Accepted: 05/16/2019] [Indexed: 11/26/2022] Open
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21
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Riefkohl‐Ortiz E, Frey JA, Yee J, David Gothard M, Hughes PG, Ballas DA, Ahmed RA. Iatrogenic Critical Care Procedure Complication Boot Camp: A Simulation-based Pilot Study. AEM EDUCATION AND TRAINING 2019; 3:188-192. [PMID: 31008431 PMCID: PMC6457349 DOI: 10.1002/aet2.10317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/22/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Traditional medical education strategies teach learners how to correctly perform procedures while neglecting to provide formal training on iatrogenic error management. Error management training (EMT) requires active exploration as well as explicit encouragement for learners to make and learn from errors during training. Simulation provides an excellent methodology to execute a curriculum on iatrogenic procedural complication management. We hypothesize that a standardized simulation-based EMT curriculum will improve learner's confidence, cognitive knowledge, and performance in iatrogenic injury management. METHODS This was a pilot, prospective, observational study performed in a simulation center using a curriculum developed to educate resident physicians on iatrogenic procedural complication management. Pre- and postintervention assessments included confidence surveys, cognitive questionnaires, and critical action checklists for six simulated procedure complications. Assessment data were analyzed using medians and interquartile ranges (IQRs), and the paired change scores were tested for median equality to zero via Wilcoxon signed rank tests with p < 0.05 considered statistically significant. RESULTS Eighteen residents participated in the study curriculum. The median (IQR) confidence increased significantly by a summed score of 12.5 (8.75-17.25; p < 0.001). Similarly, the median (IQR) knowledge significantly increased by 6 (3-8) points from the pre- to postintervention assessment (p < 0.001). For each of the simulation cases, the number of critical actions performed increased significantly (p < 0.001 to p = 0.002). CONCLUSION We demonstrated significant improvement in the confidence, clinical knowledge, and performance of critical actions after the completion of this curriculum. This pilot study provides evidence that a structured EMT curriculum is an effective method to teach management of iatrogenic injuries.
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Affiliation(s)
| | - Jennifer A. Frey
- Summa Health System–Akron CampusAkronOH
- The Ohio State UniversityColumbusOH
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22
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Ahmed RA, Hughes PG, Wong AH, Gray KM, Ballas D, Khobrani A, Selley RD, McQuown C. Iatrogenic emergency medicine procedure complications and associated trouble-shooting strategies. Int J Health Care Qual Assur 2019; 31:935-949. [PMID: 30415624 DOI: 10.1108/ijhcqa-08-2017-0157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to provide a consolidated reference for the acute management of selected iatrogenic procedural injuries occurring in the emergency department (ED). DESIGN/METHODOLOGY/APPROACH A literature search was performed utilizing PubMed, Scopus, Web of Science and Google Scholar for studies through March of 2017 investigating search terms "iatrogenic procedure complications," "error management" and "procedure complications," in addition to the search terms reflecting case reports involving the eight below listed procedure complications. FINDINGS This may be particularly helpful to academic faculty who supervise physicians in training who present a higher risk to cause such injuries. ORIGINALITY/VALUE Emergent procedures performed in the ED present a higher risk for iatrogenic injury than in more controlled settings. Many physicians are taught error-avoidance rather than how to handle errors when learning procedures. There is currently very limited literature on the error management of iatrogenic procedure complications in the ED.
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23
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Dralle H, Kols K, Agha A, Sohn M, Gockel I, Lainka M. [Arterial malpositioning of a port catheter]. Chirurg 2019; 90:149-152. [PMID: 30734079 DOI: 10.1007/s00104-018-0765-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- H Dralle
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Endokrine Chirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - K Kols
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hans-Böckler-Allee 3, 30173, Hannover, Deutschland.
| | - A Agha
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Minimal-invasive Chirurgie, Städtisches Klinikum München Bogenhausen, Englschalkinger Str. 77, 81925, München, Deutschland.
| | - M Sohn
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Minimal-invasive Chirurgie, Städtisches Klinikum München Bogenhausen, Englschalkinger Str. 77, 81925, München, Deutschland.
| | - I Gockel
- Klinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
| | - M Lainka
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Sektion Gefäßchirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
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24
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Tasopoulou KM, Argyriou C, Mantatzis M, Kantartzi K, Passadakis P, Georgiadis GS. Endovascular Repair of an Inadvertent Right Vertebral Artery Rupture during Dialysis Catheter Insertion. Ann Vasc Surg 2018; 51:324.e11-324.e16. [PMID: 29758322 DOI: 10.1016/j.avsg.2018.02.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 01/23/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
Abstract
Central venous (CV) catheterization is not only an invaluable diagnostic modality but also an essential therapeutic tool for the treating physician, enabling rapid and reliable intravenous administration of drugs and fluids, providing venous access to patients undergoing long-term continuous or repeated intravenous treatment such as chemotherapy, or it can be used for hemodialysis in patients suffering from acute or chronic renal disease. On the other hand, CV catheterization can lead to a wide range of life-threatening complications for the patient especially if left untreated or become late-diagnosed. In particular, arterial injuries are among the most feared complications that require early clinical suspicion for prompt diagnosis and management. We report the case of a 79-year-old female dialysis patient who suffered from a vertebral artery (VA) injury complicated by a herald bleeding on the third postintervention day after an internal jugular vein dialysis catheter replacement. The patient initially presented neurological signs of a stroke and urgently treated endovascularly after immediate diagnosis of VA rupture was made. Imaging techniques are evidence-based tools that help minimize these mechanical complications, including inadvertent arterial puncture and therefore should be practiced and taught in training programs to avoid the potentially devastating consequences of CV catheterization.
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Affiliation(s)
- Kalliopi-Maria Tasopoulou
- Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Christos Argyriou
- Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Michael Mantatzis
- Department of Radiology/Interventional Radiology Unit, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantia Kantartzi
- Department of Nephrology, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ploumis Passadakis
- Department of Nephrology, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - George S Georgiadis
- Department of Vascular Surgery, "Democritus" University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece.
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25
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Zoltowska D, Kalavakunta J. A Port-A-Cath in aorta. Clin Case Rep 2018; 6:957-958. [PMID: 29744099 PMCID: PMC5930234 DOI: 10.1002/ccr3.1496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/20/2018] [Accepted: 02/24/2018] [Indexed: 11/11/2022] Open
Abstract
Totally implantable venous access ports are valuable invention for oncological patients. Erroneous arterial malposition rate is estimated from 1.1% to 3.7% (Bowen et al. Am. J. Surg., 2014, 208, 937). Early recognition and management are crucial to prevent further complications.
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Affiliation(s)
- Dominika Zoltowska
- Department of Internal Medicine Western Michigan University Homer Stryker School of Medicine Kalamazoo Michigan
| | - Jagadeesh Kalavakunta
- Department of Cardiology Michigan State University/Borgess Medical Center Kalamazoo Michigan
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26
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Pepley DF, Gordon AB, Yovanoff MA, Mirkin KA, Miller SR, Han DC, Moore JZ. Training Surgical Residents With a Haptic Robotic Central Venous Catheterization Simulator. JOURNAL OF SURGICAL EDUCATION 2017; 74:1066-1073. [PMID: 28645855 PMCID: PMC5732878 DOI: 10.1016/j.jsurg.2017.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/01/2017] [Accepted: 06/05/2017] [Indexed: 05/31/2023]
Abstract
OJECTIVE Ultrasound guided central venous catheterization (CVC) is a common surgical procedure with complication rates ranging from 5 to 21 percent. Training is typically performed using manikins that do not simulate anatomical variations such as obesity and abnormal vessel positioning. The goal of this study was to develop and validate the effectiveness of a new virtual reality and force haptic based simulation platform for CVC of the right internal jugular vein. DESIGN A CVC simulation platform was developed using a haptic robotic arm, 3D position tracker, and computer visualization. The haptic robotic arm simulated needle insertion force that was based on cadaver experiments. The 3D position tracker was used as a mock ultrasound device with realistic visualization on a computer screen. Upon completion of a practice simulation, performance feedback is given to the user through a graphical user interface including scoring factors based on good CVC practice. The effectiveness of the system was evaluated by training 13 first year surgical residents using the virtual reality haptic based training system over a 3 month period. RESULTS The participants' performance increased from 52% to 96% on the baseline training scenario, approaching the average score of an expert surgeon: 98%. This also resulted in improvement in positive CVC practices including a 61% decrease between final needle tip position and vein center, a decrease in mean insertion attempts from 1.92 to 1.23, and a 12% increase in time spent aspirating the syringe throughout the procedure. CONCLUSIONS A virtual reality haptic robotic simulator for CVC was successfully developed. Surgical residents training on the simulation improved to near expert levels after three robotic training sessions. This suggests that this system could act as an effective training device for CVC.
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Affiliation(s)
- David F Pepley
- Department of Mechanical and Nuclear Engineering, Penn State, University Park, Pennsylvania
| | - Adam B Gordon
- Department of Mechanical and Nuclear Engineering, Penn State, University Park, Pennsylvania
| | - Mary A Yovanoff
- Department of Industrial Engineering, Penn State, University Park, Pennsylvania
| | - Katelin A Mirkin
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA
| | - Scarlett R Miller
- Department of Engineering Design and Industrial Engineering, Penn State, University Park, Pennsylvania
| | - David C Han
- Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA
| | - Jason Z Moore
- Department of Mechanical and Nuclear Engineering, Penn State, University Park, Pennsylvania.
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27
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Jung CW, Jalilov G, Song IK, Kim EH, Kim HS, Kim JT, Lee JH. Position and relative size of the vertebral artery according to age: Implications for internal jugular vein access. Paediatr Anaesth 2017; 27:997-1002. [PMID: 28736858 DOI: 10.1111/pan.13209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
AIM The purpose of this retrospective observational study was to investigate the anatomical characteristics of the vertebral artery in pediatric patients using computed tomography images. METHODS We evaluated anatomical characteristics of the right and left vertebral artery at the cricoid level and at a lower level, which was mid-level between the cricoid cartilage and the origin of vertebral artery from the subclavian artery. At each level, the cross-sectional areas of the vertebral artery and internal jugular vein, the relative size of vertebral artery to internal jugular vein, the minimum distance between them, and the extent of overlap between them were investigated. RESULTS According to the chest computed tomography images of 344 patients, the sizes of internal jugular vein and vertebral artery were found to increase with age. On the other hand, the relative size of the vertebral artery to internal jugular vein was found to increase conversely with decreasing age. The distance between the vertebral artery and internal jugular vein increased with age at both sides and levels. The vertebral artery was mostly located at the medial side of the internal jugular vein, and overlapped with the internal jugular vein in at least 54% of the patients at the cricoid level and in 74% at the lower level. CONCLUSION The theoretical risk of vertebral artery puncture is higher in younger children during internal jugular vein catheterization.
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Affiliation(s)
- Chul-Woo Jung
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
| | - Gulomjon Jalilov
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
| | - In-Kyung Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Korea
| | - Eun-Hee Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
| | - Hee-Soo Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
| | - Jin-Tae Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
| | - Ji-Hyun Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongnogu, Korea
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28
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Sakamoto N, Taniguchi T, Tomimatsu H, Kadoba T, Noma S, Sugimoto K. Primary Branch Vessel Embolization to Prevent Type 2 Endoleak before Stent Graft Treatment for Perforation of the Subclavian Artery. J Vasc Interv Radiol 2017; 28:762-764. [PMID: 28431652 DOI: 10.1016/j.jvir.2016.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Noriaki Sakamoto
- Department of Radiology, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan
| | - Takanori Taniguchi
- Department of Radiology, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan
| | - Hirotaka Tomimatsu
- Department of Radiology, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan
| | - Tomoya Kadoba
- Department of Radiology, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan
| | - Satoshi Noma
- Department of Radiology, Tenri Hospital, 200 Mishima-cho, Tenri City, Nara 632-8552, Japan
| | - Koji Sugimoto
- Department of Radiology, Center for Endovascular Therapy, Kobe University Hospital, Chuo-ku, Kobe, Japan
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29
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Closure Devices for Iatrogenic Thoraco-Cervical Vascular Injuries. Cardiovasc Intervent Radiol 2016; 40:381-387. [PMID: 27896414 PMCID: PMC5288421 DOI: 10.1007/s00270-016-1506-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/09/2016] [Indexed: 12/19/2022]
Abstract
Introduction The unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI). Methods A systematic review was performed according to PRISMA guidelines. Results Thirty-two relevant case series and case reports were identified with a total of 69 patients having being studied. In the majority of the studies, plug-based VCDs were used (81%) followed by suture-based devices (19%). The majority of studies reported successful outcomes from the use of VCDs in terms of achieving immediate haemostasis without any acute complications. Long-term follow-up data were only available in nine studies with only one case of carotid pseudoaneurysm being reported after 1-month post-procedure. All other cases had no reported long-term complications. Five studies performed direct or indirect comparisons between VCDs and other treatments (open surgery or stent grafting) suggesting no significant differences in safety or effectiveness. Conclusion Although there is limited evidence, VCDs appear to be safe and effective for the management of ITCAIs. Further research is warranted regarding the effectiveness of this approach in comparison to surgery and in order to identify those patients who are more likely to benefit from this minimally invasive approach.
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30
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Oh SY. Inadvertent Arterial Catheterization of Central Venous Catheter: A Case Report. JOURNAL OF TRAUMA AND INJURY 2015. [DOI: 10.20408/jti.2015.28.4.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seung-Young Oh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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