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. 2022 Sep 19;12(9):1537.
doi: 10.3390/jpm12091537.

Management of Inadvertent Arterial Catheterization during Central Venous Catheter Placement: A Case Series

Georgios Papastratigakis  1 , Diamantina Marouli  2 , Athanasia Proklou  2 , Nikolaos Nasis  3 , Eumorfia Kondili  2 , Elias Kehagias  3
Affiliations

Management of Inadvertent Arterial Catheterization during Central Venous Catheter Placement: A Case Series

Georgios Papastratigakis et al. J Pers Med. .

Abstract

Percutaneous central venous catheterization, although a widely used technique in ICU patients worldwide, is not devoid of complications even under real-time ultrasound guidance. Arterial puncture is a well-recognized complication, while unintended subclavian or carotid artery cannulations during attempted central venous catheterization are infrequent, but documented complications with potentially deleterious consequences. Recently, endovascular balloon tamponade has emerged as the preferred initial approach to repair inadvertent arterial cannulations. Herein, we present a case series of inadvertent arterial catheterization during an attempted ultrasound-guided access of the right internal jugular and the left subclavian vein that were successfully managed with endovascular balloon tamponade.

Keywords: central venous catheter; inadvertent arterial catheterization; ultrasound guidance.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) CT angiography confirming right subclavian artery catheterization, just distal to the origin of the right vertebral artery. (B) Final result after removal of the CVC with no extravasation.
Figure 2
Figure 2
(A) Digital angiography confirming right common carotid artery (CCA) catheterization with a CVC (white arrow). An angiography catheter in the arterial system is also visible (black arrow). (B) Angiography during removal of the CVC and compression of the CCA. (C) Final result after release of compression, 5 min later with no evidence of extravasation.
Figure 2
Figure 2
(A) Digital angiography confirming right common carotid artery (CCA) catheterization with a CVC (white arrow). An angiography catheter in the arterial system is also visible (black arrow). (B) Angiography during removal of the CVC and compression of the CCA. (C) Final result after release of compression, 5 min later with no evidence of extravasation.
Figure 3
Figure 3
(A) Contrast extravasation from the left SCA, after closure device failure. (B) Manual compression with balloon assisted inflation at the site of the extravasation. (C) Final result, with no extravasation.
See this image and copyright information in PMC

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