J Korean Soc Radiol.  2017 Apr;76(4):282-286. 10.3348/jksr.2017.76.4.282.

Endovascular Repair of Inadvertent Arterial Injury Induced by Central Venous Catheterization Using a Vascular Closure Device: A Case Report

• Kim SH
• Jang WJ
• Oh JH
• Song YG

• KMID: 2373966
• DOI: http://doi.org/10.3348/jksr.2017.76.4.282

Abstract

Central venous catheterization can cause various complications. Inadvertent subclavian artery catheterization was performed during insertion of a central venous catheter in a 73-year-old man suffering from panperitonitis due to small-bowel perforation. Endovascular treatment was conducted to treat the injured subclavian artery with a FemoSeal vascular closure device.

MeSH Terms

Aged
Catheterization
Catheterization, Central Venous*
Catheters
Central Venous Catheters*
Humans
Subclavian Artery
Vascular Closure Devices*
Vascular System Injuries

Figure

• 

  Fig. 1 Inadvertent subclavian artery cannulation treated by FemoSeal in a 73-year-old man. A. Chest radiography following central vein cannulation shows the abnormal position of the right central venous catheter (white arrow) with right pneumothorax. B-D. Initial CT angiography images show that the catheter is obliquely passed through the right sternocleidomastoid muscle. The catheter was placed in the right subclavian artery. E. Three-dimensional reconstruction (maximum intensity projection) of the computed tomographic angiography confirms the presence of an inadvertently inserted catheter in the right subclavian artery. F. Schematic drawing of the arteriotomy site using a FemoSeal closure device. It shows the Inner Seal (d) sitting abut with the inner wall of the artery (thick black arrow) and the Outer Locking Disc (c) sealing the puncture site from outside of the artery (thin black arrow). a = skin, b = artery, c = FemoSeal Outer Locking Disc, d = Inner Seal G. Angiography performed immediately after deployment of the FemoSeal device shows no extravasation of contrast with preservation of the major arteries. H. Three weeks later, follow up CT angiography reveals an intact right subclavian artery (white arrow).

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