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Pradhan S, Vanderlaan RD, Benson L. Extravascular Central Venous Line Removal and Endovascular Covered Stent Implantation Guided by 3-Dimensional Computed Tomographic Reconstruction. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:83-85. [PMID: 38774682 PMCID: PMC11103029 DOI: 10.1016/j.cjcpc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/30/2023] [Indexed: 05/24/2024]
Affiliation(s)
- Sarah Pradhan
- Department of Pediatrics, Division of Cardiology, the Hospital for Sick Children, Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rachel D. Vanderlaan
- Department of Surgery, Division of Cardiovascular Surgery, the Hospital for Sick Children, Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lee Benson
- Department of Pediatrics, Division of Cardiology, the Hospital for Sick Children, Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada
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2
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Rey Chaves CE, Orozco C, Posada E, Gómez Zuleta M, Fajardo E, Barón V, Hernández Rodríguez OG. Percutaneous closure of subclavian iatrogenic injuries after central venous catheterization: a Latin American experience. Front Surg 2023; 10:1309920. [PMID: 38186387 PMCID: PMC10766753 DOI: 10.3389/fsurg.2023.1309920] [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: 10/08/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Arterial injuries following central venous catheterization (CVC) range between 0.1%-2.7%. The open surgical approach could be related to increased rates of morbidity and mortality. Vascular closure devices (VCD) are often used for the management of these patients with a success rate of up to 80%. Objectives Describe our experience in managing arterial vascular injuries following central venous catheterization with Perclose ProGlide (Abbott Vascular IncSanta Clara, CA, USA). Methods A retrospective review of all patients over 18 years old who underwent percutaneous closure of arterial injuries following central venous catheterization in our center between January 2018 and May 2023 was included and reported with a 90-day follow-up. Results 3 Patients were included, in all cases, access to the CVC were right with a subclavian artery injury. Ultrasound and fluoroscopy guide was used in all cases. For the 3 cases, a percutaneous technique using Perclose ProGlide (Abbott Vascular IncSanta Clara, CA, USA) was performed. With a 100% success rate, and no complications evidenced after 90 days of follow-up. Conclusion Inadvertent arterial catheterization it's a non-negligible complication after CVC placement. VCD could be considered a safe and feasible approach for the management of these traumatic injuries.
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Affiliation(s)
- Carlos Eduardo Rey Chaves
- Estudiante de Posgrado Cirugía General, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Claudia Orozco
- Estudiante de Posgrado Cirugía General, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Eduardo Posada
- Estudiante de Posgrado Cirugía General, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María Gómez Zuleta
- Cirugía General, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Ernesto Fajardo
- Cirugía Vascular Periférica, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Vladimir Barón
- Cirugía Vascular Periférica, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Oscar Geovanny Hernández Rodríguez
- Cirugía Vascular Periférica, Facultad de Medicina, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
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3
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Wang L, Bai J, Jin J, Zhi K, Nie S, Qu L. Treatment of inadvertent cervical arterial catheterization: Single-center experience. Vascular 2023; 31:791-798. [PMID: 35422197 DOI: 10.1177/17085381221083161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Inadvertent arterial catheterization can occur during transjugular central venous catheter insertion and should be promptly treated to prevent serious consequences. Although many treatment modalities are available, no exist guidelines regarding the selection of treatment. We aimed to describe our experience with the treatment of 11 patients who underwent inadvertent cervical arterial catheterization and propose an algorithm for the selection of treatment methods. METHODS We retrospectively identified all patients who were treated for inadvertent arterial catheterization at our center between January 2016 and March 2021. We reviewed patient profiles, images, treatment methods, and follow-up data. RESULTS Eleven patients were included (eight men and three women, age: 36-73 years). Ten catheter misplacements were in the right common carotid artery. The remaining catheter was inserted into the right subclavian artery after penetrating the right common carotid artery. Two catheters were 5-Fr and nine catheters were 11.5-Fr. Two patients underwent manual compressions, three underwent open surgery, three underwent stent-graft repairs, and four underwent Perclose Proglide closure. Clinical success was achieved in all 11 patients. Primary technical success was achieved in 10 patients. In one patient, unsuccessful manual compression was followed by successful stent-graft repair; the manual compression failed to prevent bleeding, possibly because of the long-term oral administration of aspirin for coronary heart disease. The mean follow-up was 5.4 months (range, 1-12 months). The overall mortality rate was zero, and no vascular or neurological events occurred. CONCLUSIONS The existing data show that the current protocol for the treatment of inadvertent cervical arterial catheterization at our center is safe and effective. However, the data are insufficient and require further clinical validation.
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Affiliation(s)
- Liang Wang
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jun Bai
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jie Jin
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Kangkang Zhi
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Shaojie Nie
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Lefeng Qu
- Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China
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4
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Fontana F, Piacentino F, Curti M, Ierardi AM, Coppola A, Macchi E, De Marchi G, Faiella E, Santucci D, Moramarco LP, Del Grande F, Piffaretti G, Tozzi M, Imperatori A, Carcano G, Basile A, D'Angelo F, Carrafiello G, Venturini M. Pulmonary Artery Pseudoaneurysms Embolization: Bicentric Experience and Review of the Literature. J Clin Med 2023; 12:jcm12113796. [PMID: 37297991 DOI: 10.3390/jcm12113796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023] Open
Abstract
The purpose of this bicentric case series was to report the safety, efficacy, and clinical outcome of transcatheter embolization in pulmonary artery pseudoaneurysms (PAPAs). Between January 2016 and June 2021, eight patients with PAPA were subjected to transcatheter embolization. The total number of patients was eight, of which five were female, with a mean age of 62 ± 14 years (average ± standard deviation). Etiology was traumatic in 2/8 cases and iatrogenic in 6/8 cases (after positioning a Swan-Ganz catheter in 5/6 cases and a temporary pacemaker in the latter case). In a single case, the PAPA was incidentally discovered during a routine X-ray, in the remaining 7 cases, the procedure was performed in emergency settings. PAPA embolization was performed using detachable coils alone in 3 cases; coils and glue in 1 case; coils, glue, and vascular plug in 1 case; coils and non-adhesive liquid embolic agents (Onyx and Squid respectively) in 2 cases; and non-adhesive liquid embolic agent alone (Onyx) in 1 case. No peri-procedural or post-procedural complications were recorded. Both the technical and clinical success rates were 100.0%. In conclusion, endovascular embolization is a technically feasible and safe therapeutic option for patients with PAPAs.
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Affiliation(s)
- Federico Fontana
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
| | - Marco Curti
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Anna Maria Ierardi
- Radiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20021 Milan, Italy
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Edoardo Macchi
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Giuseppe De Marchi
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Eliodoro Faiella
- Radiology Unit, Sant'Anna Hospital, San Fermo della Battaglia, 22042 Como, Italy
- Department of Radiology, Campus Bio-Medico University, 00128 Rome, Italy
| | - Domiziana Santucci
- Radiology Unit, Sant'Anna Hospital, San Fermo della Battaglia, 22042 Como, Italy
- Department of Radiology, Campus Bio-Medico University, 00128 Rome, Italy
| | | | - Filippo Del Grande
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale EOC, 6900 Lugano, Switzerland
| | - Gabriele Piffaretti
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
- Vascular Surgery Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Matteo Tozzi
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
- Vascular Surgery Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Andrea Imperatori
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
- Thoracic Surgery Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Giulio Carcano
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
- General Surgery Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Antonio Basile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", 95123 Catania, Italy
| | - Fabio D'Angelo
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
- Orthopedic Surgery Unit, ASST Settelaghi, 21100 Varese, Italy
| | - Gianpaolo Carrafiello
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122 Milan, Italy
- Radiology Unit, Sant'Anna Hospital, San Fermo della Battaglia, 22042 Como, Italy
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, ASST Settelaghi, 21100 Varese, Italy
- Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy
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5
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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 Imaging Guangzhou Twelfth People's Hospital Guangzhou Guangdong China
| | - Yong Chen
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital Southern Medical University Guangzhou Guangdong China
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6
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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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7
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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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8
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Shiu WHL. Inadvertent cannulation of subclavian artery in central venous catheter insertion: A case report and review of prevention and management. J Clin Imaging Sci 2022; 12:34. [PMID: 35769095 PMCID: PMC9235425 DOI: 10.25259/jcis_50_2022] [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: 05/13/2022] [Accepted: 06/04/2022] [Indexed: 11/24/2022] Open
Abstract
Central venous catheter is a commonly performed procedure in which inadvertent arterial puncture is a known complication. Inadvertent arterial injury with a large-bore catheter is associated with significant morbidity and there are a few endovascular techniques to repair the injury, including the use of a percutaneous closure device and a covered stent placement. We report a case of a patient with complex medical history complicated by inadvertent right subclavian artery injury during central venous catheter insertion. The catheter was immediately removed. The right subclavian arterial injury was repaired with a stent-graft.
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Affiliation(s)
- Wai Hung Lester Shiu
- Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
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9
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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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10
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Thet MS, Kyaw Tun J, Oo AY, Lopez-Marco A. Ministernotomy repair of inadvertent proximal right subclavian artery injury following right internal jugular central venous catheter insertion. BMJ Case Rep 2022; 15:e247809. [PMID: 35459649 PMCID: PMC9036171 DOI: 10.1136/bcr-2021-247809] [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] [Accepted: 04/07/2022] [Indexed: 11/04/2022] Open
Abstract
A man in his 60s was referred for urgent coronary artery bypass grafting (CABG) procedure following acute coronary syndrome. After induction of general anaesthesia, right jugular venous catheterisation under two-dimensional ultrasound guidance was planned as part of perioperative management. While obtaining vascular access, the pulsatile flow was noted once the dilator was inserted, having to abandon the procedure and immediately apply manual pressure. CT angiogram showed proximal right subclavian artery injury with active contrast extravasation and resultant large haematoma in the neck. The patient underwent urgent exploration of the injured vessel through a J-shaped ministernotomy, and primary repair of the artery was performed. The patient recovered from the procedure without any complications. He continued to stay in the hospital for a few days, afterwards, he underwent the initially planned CABG surgery. He was discharged home on day 5 after surgery without further concerns.
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Affiliation(s)
- Myat Soe Thet
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Jimmy Kyaw Tun
- Department of Interventional Radiology, The Royal London Hospital, London, UK
| | - Aung Ye Oo
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
| | - Ana Lopez-Marco
- Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
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11
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Raja Shariff RE, Ibrahim KS, Khir RN, Ismail JR, Undok AW. Managing iatrogenic subclavian artery cannulation using a vascular closure device: a minimally invasive option. Postgrad Med J 2021; 98:e4-e5. [PMID: 37066558 DOI: 10.1136/postgradmedj-2021-140706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/30/2021] [Indexed: 11/04/2022]
Affiliation(s)
- R E Raja Shariff
- Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
| | - K S Ibrahim
- Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
| | - R N Khir
- Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
| | - J R Ismail
- Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
| | - A W Undok
- Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
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12
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Verloh N, Scharf G, Bäumler W, Pfister K, Oikonomou K, Stroszczynski C, Uller W, Dollinger M. Erroneous placement of central venous catheters in subclavian artery: Retrieval and successful hemostasis with a femoral closure device. J Vasc Access 2021; 23:692-697. [PMID: 33827311 DOI: 10.1177/11297298211007704] [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
BACKGROUND Retrospective evaluation of the safety and efficacy of the retrieval of misplaced central venous catheters (CVCs) in subclavian arteries using the femoral closure device Angio-Seal™. METHODS The clinical data of five patients (female, n = 2; mean age, 55.0 years ± 11.9) in whom a misplaced CVC within a subclavian artery was removed followed by closure of the vessel entry site with 8-French (F) Angio-Seal™ was analyzed. RESULTS In 4/5 patients (80%; CVC diameter, 7-8F) the procedure was technically successful without complications. In 1/5 patients (20%; CVC diameter, 11.5F) the procedure failed and an additional covered stent was placed for successful closure of the vessel entry site. There were no complications associated with the Angio-Seal™ or stent implantation during follow-up. CONCLUSION Retrieval of a misplaced CVC within a subclavian artery using the percutaneous closure device Angio-Seal™ is quite safe and effective; however, caution is required if there is a mismatch in the diameter of the Angio-Seal™ and CVC. In the case of procedure failure, successful closure of the vessel entry site can be achieved by covered stent placement.
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Affiliation(s)
- Niklas Verloh
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Gregor Scharf
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Wolf Bäumler
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Karin Pfister
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Kyriakos Oikonomou
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Wibke Uller
- Department of Radiology, University Hospital Freiburg, Freiburg, Germany
| | - Marco Dollinger
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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13
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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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Gunawardena T, Cassim R, Wijeyaratne M. Accidental carotid artery cannulation during internal jugular vein access for hemodialysis. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2021. [DOI: 10.4103/ijves.ijves_53_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ormiston W, Merrilees S, Hill A, Brew S, McGuinness B, Holden A. Management of Inadvertent Proximal Vertebral Artery Cannulation by a Combined Endovascular/Surgical Approach. Cardiovasc Intervent Radiol 2020; 43:1946-1948. [PMID: 32851426 DOI: 10.1007/s00270-020-02619-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Affiliation(s)
- William Ormiston
- Department of Interventional Radiology, Auckland City Hospital, Auckland, New Zealand.
| | - Stephen Merrilees
- Department of Interventional Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Andrew Hill
- Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Stefan Brew
- Department of Interventional Neuroradiology, Auckland City Hospital, Auckland, New Zealand
| | - Ben McGuinness
- Department of Interventional Neuroradiology, Auckland City Hospital, Auckland, New Zealand
| | - Andrew Holden
- Department of Interventional Radiology, Auckland City Hospital, Auckland, New Zealand
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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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