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Xu LY, Chen DJ, Wang SS, Chen L, Qi F, Liu MM. Management of venous perforation during central venous catheterization in hemodialysis patients: Three case reports. Medicine (Baltimore) 2019; 98:e16182. [PMID: 31232976 PMCID: PMC6636942 DOI: 10.1097/md.0000000000016182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE In recent years, central venous catheterization (CVC) has become widely used for hemodialysis patients. Based on 3 cases, we discussed the detection and management of venous perforation at an early stage. PATIENTS CONCERNS Patients 1 (male, 77 years), 2 (male, 82 years), and 3 (male, 30 years) were diagnosed with uremia and underwent hemodialysis. DIAGNOSES Computed tomography suggested pneumomediastinum in patient 1 and pneumothorax in patient 2 after a replacement of the temporary hemodialysis catheter. In patient 3, X-ray suggested that the tip of the catheter was approximately at the plane of the fifth thoracic vertebrate after the temporary catheter was placed. INTERVENTIONS In patients 1 and 2, the catheters were maintained where they were for about 2 weeks until a false lumen formed outside the catheter. In patient 3, the catheter was withdrawn at once when vein perforation was observed. OUTCOME In patients 1 and 2, the catheters were adjusted successfully under digital subtraction angiography (DSA) guidance 2 weeks later. In patient 3, hemothorax developed, and a total of approximately 1000 mL of bloody fluid was drained. LESSONS When venous perforation occurs during CVC, it is safer and more reliable to adjust or withdraw the catheter under DSA guidance after a false lumen forms outside the catheter.
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Zeng Z, Chen Y, Song Y, Lin F. Internal mammary artery injury during percutaneous coronary intervention: a case report. BMC Cardiovasc Disord 2018; 18:222. [PMID: 30514236 PMCID: PMC6280442 DOI: 10.1186/s12872-018-0972-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 11/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is widely used to treat coronary artery disease (CAD). However, complications of PCI are inevitable. Internal mammary artery (IMA) injury is an infrequent but potentially lethal complication of PCI. CASE PRESENTATION A 78-year-old man was diagnosed with multivessel lesions by coronary angiography. The IMA was injured during PCI, then cured by early identification and active rescue. CONCLUSIONS This is the first reported case, to our knowledge, of injury to the IMA during PCI. We we report this case to discuss how to treat this injury effectively and avoid this complication during clinical therapy.
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Affiliation(s)
- Zhicong Zeng
- Cardiology Department, Affiliated Baoan TCM Hospital, Guangzhou University of Traditional Chinese Medicine, No.25, Yuan Second Road, Shenzhen City, Guangdong Province, People's Republic of China
| | - Yaqin Chen
- Cardiology Department, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yinzhi Song
- Cardiology Department, Affiliated Baoan TCM Hospital, Guangzhou University of Traditional Chinese Medicine, No.25, Yuan Second Road, Shenzhen City, Guangdong Province, People's Republic of China
| | - Fengxia Lin
- Cardiology Department, Affiliated Baoan TCM Hospital, Guangzhou University of Traditional Chinese Medicine, No.25, Yuan Second Road, Shenzhen City, Guangdong Province, People's Republic of China.
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Kela M, Munde H, Raut S. Accidental placement of central venous catheter into internal mammary vein: A rare catheter malposition. Ann Card Anaesth 2018; 20:477-478. [PMID: 28994693 PMCID: PMC5661327 DOI: 10.4103/aca.aca_106_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manish Kela
- Department of Cardiac Anesthesia, Seven Hills Hospital, Andheri, Mumbai, Maharashtra, India
| | - Haridas Munde
- Department of Cardiac Anesthesia, Seven Hills Hospital, Andheri, Mumbai, Maharashtra, India
| | - Sushil Raut
- Department of Cardiac Anesthesia, Seven Hills Hospital, Andheri, Mumbai, Maharashtra, India
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Jiang Z, Yang J, Wang X. Endovascular coil embolization and stenting for the treatment of iatrogenic right internal mammary artery injury: A case report. J Int Med Res 2018; 46:1271-1276. [PMID: 29322817 PMCID: PMC5972256 DOI: 10.1177/0300060517740307] [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: 11/25/2022] Open
Abstract
A 54-year-old Chinese woman presented with a 10-year history of repeated paroxysmal palpitations. She was diagnosed with paroxysmal supraventricular tachycardia by 12-lead electrocardiogram and was advised to undergo catheter-based radiofrequency ablation. During the procedure, a rare complication occurred that was diagnosed as a right internal mammary artery penetrating injury. After appropriate emergency treatment with arterial embolization and membrane-covered stent implantation, the patient was out of immediate danger of haemorrhaging. Follow-up computed tomography angiography of the subclavian artery at 3 months after she was discharged from hospital revealed stent-graft patency with no evidence of in-stent thrombosis or stent stenosis. No problems were observed at the 6-month follow-up visit.
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Affiliation(s)
- Zhen Jiang
- 1 Department of Cardiology, First Affiliated Hospital, 26441 School of Medicine, Zhejiang University , Hangzhou, Zhejiang Province, China
| | - JinXiu Yang
- 2 Department of Cardiology, First Affiliated Hospital, 70571 Zhejiang Chinese Medicine University , Hangzhou, Zhejiang Province, China
| | - XingXiang Wang
- 1 Department of Cardiology, First Affiliated Hospital, 26441 School of Medicine, Zhejiang University , Hangzhou, Zhejiang Province, China
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Munta K, Venkategowda PM, Chaudhary JR, Rao SM, Amte R. Accidental placement of central venous catheter tip into internal mammary vein. Indian J Crit Care Med 2015. [PMID: 26195868 PMCID: PMC4478683 DOI: 10.4103/0972-5229.158290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kartik Munta
- Department of Critical Care Medicine, Yashoda Multi-Speciality Hospital, Shantishikara Apartments, D4, #124, Bedind Enadu Bld, Rajbhavan Road, Somajiguda, Hyderabad, Telangana, India
| | - Pradeep M Venkategowda
- Department of Critical Care Medicine, Yashoda Multi-Speciality Hospital, Shantishikara Apartments, D4, #124, Bedind Enadu Bld, Rajbhavan Road, Somajiguda, Hyderabad, Telangana, India
| | - Jaydeep Ray Chaudhary
- Department of Neurology, Yashoda Multi-Speciality Hospital, Shantishikara Apartments, D4, #124, Bedind Enadu Bld, Rajbhavan Road, Somajiguda, Hyderabad, Telangana, India
| | - S Manimala Rao
- Department of Critical Care Medicine, Yashoda Multi-Speciality Hospital, Shantishikara Apartments, D4, #124, Bedind Enadu Bld, Rajbhavan Road, Somajiguda, Hyderabad, Telangana, India
| | - Rahul Amte
- Department of Critical Care Medicine, Yashoda Multi-Speciality Hospital, Shantishikara Apartments, D4, #124, Bedind Enadu Bld, Rajbhavan Road, Somajiguda, Hyderabad, Telangana, India
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Complications of 1309 Internal Jugular Vein Cannulations with the Anatomic Landmarks Technique in Infants and Children. J Vasc Access 2011; 13:198-202. [PMID: 22020528 DOI: 10.5301/jva.5000022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2011] [Indexed: 11/20/2022] Open
Abstract
Purpose Report the procedural complications of internal jugular vein (IJV) catheter insertion in infants and children and discuss how to prevent them. Methods An observational study was performed from January 2006 to August 2010; 1309 internal jugular vein cannulae were inserted in the operating room by either staff or resident anesthesiologists. Patient age, weight, sex, type of catheter (diameter, lumen number), number of attempts, and complications were recorded. The discussion is focused on how to prevent or reduce internal jugular vein line insertion related complications in infants and children. Results 1309 IJV cannulae were inserted, 85.63% of catheters placed were successful after one to three attempts. Complications included 12 arrhythmias (0.91%), 25 arterial punctures (1.90%), 16 hematomas (1.22%), 17 device occlusions, breaks or malpositions (1.29%), 11 line-related infections (0.84%), four cases of thrombus (0.31%), two cardiopulmonary arrests (0.15%), two hemothoraces (0.15%), five pneumothoraces (0.38%), and one guidewire winding (0.07%). The complication rates of resident anesthesiologists were significantly higher compared to staff anesthesiologists for both common and rare complications (4.27% versus 2.21%; 0.68% versus 0.07%, respectively). In addition, residents' number of attempts were greater than staff anesthesiologists (1.84 and 1.38, respectively). Conclusions The IJV catheterization was feasible in infants and children. To reduce the risk of complications, the procedure should be performed or supervised by staff anesthesiologists; inserting the needle, guidewire, dilator, and the catheter too far should be avoided. It is now commonly accepted that all central venous cannulations should be performed under ultrasound guidance, especially in children.
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Mazeh H, Alaiyan B, Vald O, Mizrahi I, Klimov A, Eid A, Freund HR. Internal mammary artery injury during central venous catheter insertion for TPN: Rare but fatal. Nutrition 2010; 26:849-51. [DOI: 10.1016/j.nut.2010.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 11/16/2009] [Accepted: 01/01/2010] [Indexed: 10/19/2022]
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Askegard-Giesmann JR, Caniano DA, Kenney BD. Rare but serious complications of central line insertion. Semin Pediatr Surg 2009; 18:73-83. [PMID: 19348995 DOI: 10.1053/j.sempedsurg.2009.02.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Discussions on the complications of central venous catheterization in children typically focus on infectious and the more common mechanical complications of pneumothorax, hemothorax, or thrombosis. Rare complications are often more life-threatening, and inexperience may compound the problem. Central venous catheter complications can be broken down into early or late, depending on when they occur. The more serious complications are typically mechanical and occur early, but delayed presentations of pericardial effusions, cardiac tamponade, and pleural effusions may be of equal severity, and delay in diagnosis can be catastrophic. Careful insertion techniques, as well as continued vigilance in the correct position and function of central venous catheters, are imperative to help prevent serious complications.
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