Vasc Spec Int.  2022 Jun;38(2):22. 10.5758/vsi.220015.

Physician-Modified Fenestrated Endovascular Repair for Iatrogenic Innominate Vein Injury

• Lee KB
• Pyun AJ
• Praeger J
• Ziegler KR
• Han SM

• KMID: 2530922
• DOI: http://doi.org/10.5758/vsi.220015

Abstract

Iatrogenic innominate vein injuries are rare complications associated with internal jugular venous catheters. These complications are accompanied by high morbidity and mortality rates in patients with severe underlying medical conditions. Without proper treatment, emergency surgery may be needed due to acute cardiac tamponade or hemothorax. Endovascular repair can be advantageous for patients with significant medical comorbidities. Herein, we report the case of a 62-year-old female with an iatrogenic injury to the innominate vein at the subclavian vein and internal jugular confluence due to a malpositioned left internal jugular catheter. A customized fenestrated endograft was positioned with fenestration oriented to the internal jugular vein and a new tunneled catheter was inserted across the fenestration into the superior vena cava upon removal of the malpositioned catheter. In addition, a brachio-basilic arteriovenous fistula was created. At one month followup, the patient had a palpable thrill over the arteriovenous fistula and a functioning tunneled catheter.

Keyword

Endovascular procedures; Endovascular procedures; Iatrogenic disease; Iatrogenic disease; Brachiocephalic vein; Brachiocephalic vein; Jugular veins; Jugular veins