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Case Reports
. 2023 Sep 12;9(5):20230015.
doi: 10.1259/bjrcr.20230015. eCollection 2023 Oct.

ProGlide entrapment of the occlusive balloon during repair of an iatrogenic subclavian artery injury

Benjamin Jr Kemp  1 , Daniel J Kearns  1 , Raman Uberoi  1
Affiliations
Case Reports

ProGlide entrapment of the occlusive balloon during repair of an iatrogenic subclavian artery injury

Benjamin Jr Kemp et al. BJR Case Rep. .

Abstract

The insertion of any central venous catheter (CVC) is associated with a risk of damage to neurovascular structures, pneumothorax, cardiac arrhythmias, and infection1. Unintentional arterial puncture remains rare, occurring in 6.3-9.4% of attempted internal jugular vein (IJV) catheterisation and 3.1-4.9% of attempted subclavian vein catheterisation2. We present a previously undocumented complication encountered while utilising the Perclose ProGlide device in the case of a 59-year-old male who underwent right subclavian artery closure following the accidental insertion of a 14Fr Vascath into the right subclavian artery. This was performed using two ProGlide devices and one Angio-Seal device. Following deployment of the ProGlide devices, an uninflated balloon passed into the subclavian artery as a precaution, but not used, was removed. One of the ProGlide devices became dislodged having been deployed into the balloon, threatening haemostasis.

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Figures

Figure 1.
Figure 1.
The misplaced large-bore Vascath is projected to the left of the trachea with the tip in the brachiocephalic artery. Note the correctly placed right internal jugular CVC.
Figure 2.
Figure 2.
Following removal of the Vascath over a wire the proximity of the puncture site (white arrow) to the origin of the right vertebral artery (black arrow) is clear. Note the uninflated ‘safety-balloon’ within the right subclavian artery.
Figure 3.
Figure 3.
The ProGlide device deployed within the ‘safety-balloon’. This was removed without incident from the femoral artery puncture site.
See this image and copyright information in PMC

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