Korean J Crit Care Med.  2015 May;30(2):119-122. 10.4266/kjccm.2015.30.2.119.

Subclavian Artery Laceration Caused by Pigtail Catheter Removal in a Patient with Pneumothorax

• Kim HJ
• Cho YH
• Suh GY
• Yang JH
• Jeon K

• KMID: 2227679
• DOI: http://doi.org/10.4266/kjccm.2015.30.2.119

Abstract

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.

Keyword

hemothorax; laceration; pneumothorax; subclavian artery; thoracostomy

MeSH Terms

Angiography
Balloon Occlusion
Catheters*
Drainage
Hemothorax
Humans
Lacerations*
Pneumothorax*
Subclavian Artery*
Thoracostomy

Figure

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  Fig. 1. An 8.5 Fr pigtail catheter was inserted into the 1st intercostal space in the midclavicular line under fluoroscopic guidance using the Seldinger technique for the management of left pneumothorax.

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  Fig. 2. Angiography showed extravasation of the dye from the left subclavian artery (A). The pig tail catheter seems to be placed over the subclavian artery (reconstructed image, B).

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  Fig. 3. Occlusion with a compliant balloon (13 mm in diameter) was done at the level of the left proximal subclavian artery. When radiocontrast dye was injected into the proximal subclavian artery, dye did not pass distal portion from the balloon.

Reference

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