Saving Subclavian Arteries with Percutaneous Approach: a Solution for Catheter Misplacement
DOI:
https://doi.org/10.48729/pjctvs.536Keywords:
central venous catheterization, arterial iatrogenic injuries, vascular closure devices, critical careAbstract
Introduction: Inadvertent placement of a central venous catheter (CVC) into a major artery can lead to potentially devastating complications. In critically ill patients, the use of vascular closure devices is an attractive therapeutic option. We report two cases of catheter misplacement into cervical arteries managed with the Perclose ProStyle® system.
Methods: A retrospective analysis was conducted on adult patients admitted to the Intensive Care Unit (ICU) between July and December 2023 who underwent removal of a misplaced catheter using an endovascular approach.
Results: Two patients were identified. One catheterization occurred in the operating room prior to ICU admission, and the other in the ICU. Misplacement was detected within six hours via chest radiography, and diagnosis was confirmed by computed tomography angiography (CTA). Catheters were removed using the Perclose ProStyle® device.
Conclusion: The ProStyle® system was safe and effective in these patients. These cases highlight the importance of detailed procedural documentation during CVC placement. Additionally, periodic audits could help prevent technical errors and reinforce adherence to best clinical practices.
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Lorenzo JF, Rey JV, Arquillo IL, Enciso de Sa JM. Off-label use of Progride percutaneous closure device in iatrogenic arterial catheterizations: Our experience. Vascular. 2020;28(6):756-9.
Rey Chaves CE, Orozco C, Posada E, Gomez Zuleta M, Fajardo E, Baron V, et al. Percutaneous closure of subclavian iatrogenic injuries after central venous catheterization: a Latin American experience. Front Surg. 2023;10:1309920.
Shin HJ, Na HS, Koh WU, Ro YJ, Lee JM, Choi YJ, et al. Complications in internal jugular vs subclavian ultrasoundguided central venous catheterization: a comparative randomized trial. Intensive Care Med. 2019;45(7):968-76.
Gabriele P, Emanuele G, Ilenia DS, Carlo GC, Luca F, Luciano C. Management of Inadvertent Supra-aortic Arterial Lesions During Central Venous Access Procedures: Report of Six Cases and Proposed Algorithm. Ann Vasc Surg. 2021;75:308-14.
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(2):e34911.
Subramanian A, Richards N. Central Venous Catheter Placement Gone Awry: A Case Report of Right Internal Jugular Central Line Entering Subclavian Artery. Cureus. 2022;14(11):e31093.
Wang L, Bai J, Jin J, Zhi K, Nie S, Qu L. Treatment of inadvertent cervical arterial catheterization: Single-center experience. Vascular. 2023;31(4):791-8.
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(1):58.
Al Adas Z, Uceda D, Mazur A, Zehner K, Agrusa CJ, Wang G, et al. Safety and learning curve of percutaneous axillary artery access for complex endovascular aortic procedures. J Vasc Surg. 2024;79(3):487-96.
Moak JH, Swann KC, Kongkatong MM, Ottenhoff JE, Thom CD. Sonographic Detection of iatrogenic Carotid Artery Guidewires During Internal Jugular Vein Catheterization. Pocus j. 2024;9(2):88-92.
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