An unusual route taken by a central venous catheter resulting in inadvertent subclavian artery cannulation: a case report

Ultrasound-guided cannulation of a central venous catheter into the internal jugular vein (IJV) was performed in the intensive care unit for a critically ill patient. The catheter was inserted into the subclavian artery distally, despite prior ultrasound confirmation of the guidewire position using...

Full description

Saved in:
Bibliographic Details
Published in:Oxford Medical Case Reports 2015-06, Vol.2015 (6), p.303-305
Main Authors: Tan, Angela Yun June, Chan, Diana Xin Hui, Soh, Chai Rick
Format: Article
Language:English
Subjects:
Case Reports
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:Ultrasound-guided cannulation of a central venous catheter into the internal jugular vein (IJV) was performed in the intensive care unit for a critically ill patient. The catheter was inserted into the subclavian artery distally, despite prior ultrasound confirmation of the guidewire position using both the in-plane and out-of-plane views. The catheter was removed successfully by the interventional radiologist with a closure device. To our knowledge, there have been previous case reports of subclavian artery injury during IJV cannulation with ultrasound guidance, but rarely in the setting whereby the guidewire was visualized before dilatation and railroading of the catheter. This case demonstrates that the confirmation of the guidewire in the proximal segment of the vein is insufficient to exclude arterial cannulation.
ISSN:2053-8855
2053-8855
DOI:10.1093/omcr/omv042