Inadvertent subclavian artery cannulation treated by percutaneous closure

Abstract Accidental arterial puncture occurs in around 1% and 2.7% of jugular and subclavian approaches, respectively. When a line has been inadvertently inserted into an artery at a noncompressible site, there is an increased risk for serious complications. This complication can be treated by eithe...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical neuroscience 2014-11, Vol.21 (11), p.1973-1975
Main Authors: Cohen, José E, Moshe Gomori, J, Anner, Haim, Itshayek, Eyal
Format: Article
Language:English
Subjects:
Adult
Angioplasty - methods
Catheterization, Central Venous
Hemorrhage
Humans
Iatrogenic cannulation
Male
Neurology
Punctures
Stent graft
Subclavian artery
Subclavian Artery - injuries
Subclavian Artery - surgery
Vascular closure device
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Accidental arterial puncture occurs in around 1% and 2.7% of jugular and subclavian approaches, respectively. When a line has been inadvertently inserted into an artery at a noncompressible site, there is an increased risk for serious complications. This complication can be treated by either surgical or endovascular intervention or a combination; however, in critically ill patients or in those with impaired coagulation, therapeutic options are more limited. We describe successful endovascular management of inadvertent subclavian artery cannulation during insertion of a triple lumen central line catheter in a 35-year-old man suffering from leukemia, with sepsis and multi-organ failure. He was hypotensive and hemodynamically unstable, with severe coagulopathy. The catheter had entered the artery at the level of the origin of the internal mammary artery, just above the origin of the vertebral artery. The tip was lying in the aortic arch. The artery was successfully closed by endovascular deployment of an 8 French Angio-Seal device (St. Jude Medical, St. Paul, MN, USA). The device is licensed for use in femoral arterial puncture sites but provided safe and effective closure of the subclavian artery puncture in our patient.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2014.04.009