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Case Reports
. 2023 Mar 28;9(3):101164.
doi: 10.1016/j.jvscit.2023.101164. eCollection 2023 Sep.

Accidental central venous catheter cannulation into aberrant arterial anatomy requiring endovascular intervention

Spencer J Lucas  1 , Eric Bready  2 , Charles A Banks  2 , William F Gaillard  2 , Adam W Beck  2 , Emily Spangler  2
Affiliations
Case Reports

Accidental central venous catheter cannulation into aberrant arterial anatomy requiring endovascular intervention

Spencer J Lucas et al. J Vasc Surg Cases Innov Tech. .

Abstract

Central venous catheter placement continues to be an extremely common procedure throughout hospital systems. Although ultrasound guidance can mitigate some placement risks, misplacement of lines into neighboring structures, such as arteries, remains an unfortunate complication. In this report, we will discuss an 83-year-old female with aberrant left subclavian artery and right sided arch, which provided for successful stent graft coverage of arterial injury secondary to accidental subclavian artery cannulation with a central venous catheter with preservation of the right common carotid artery and avoidance of a potentially morbid sternotomy.

Keywords: Aberrant aortic arch; Aberrant left subclavian artery; Central venous catheter misplacement; Kommerell’s diverticulum; Right-sided aortic arch..

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Figures

Fig 1
Fig 1
Chest X ray from outside hospital suggestive of mispositioned central venous cathether (CVC).
Fig 2
Fig 2
A, Coronal view computed tomography scan showing the patient’s aberrant right common carotid artery (CCA) off the proximal aortic arch (red arrow) and the central venous cathether (CVC) within the subclavian artery (SCA) and cannulating the aortic arch (green arrow). B, Three-dimensional reconstruction with labels. IVC, Inferior vena cava.
Fig 3
Fig 3
Intraoperative angiogram showing cannulation of the right subclavian artery (SCA) with the central venous catheter (CVC) (red arrow) just proximal to the vertebral artery takeoff (A). Postoperative angiogram of the left SCA showing no extravasation of contrast (B).
See this image and copyright information in PMC

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