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Viabahn Stent Graft for Inadvertent insertion of a central venous catheter in the Subclavian Artery

World Journal of Cardiovascular Diseases 2022年第7期12卷 397-402页

作者： Yuchen Cao Masaaki Koide Masakazu Watanabe Division of Cardiovascular Surgery Seirei Hamamatsu General Hospital Hamamatsu Japan

Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94-year-old man with an iatrogenic right SCA injury resulting from a misplaced CVC. Computed tomography revealed the catheter piercing the right internal jugular vein to enter the right SCA and then reaching the aortic arch. Emergent endovascular treatment was performed, and a 13-mm × 50-mm self-expanding Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via the right brachial artery. The misplaced catheter was successfully removed under simultaneous postdeployment balloon dilatation. This case highlights the utility of the Viabahn stent graft for iatrogenic right SCA injury caused by a misplaced CVC and presents some insights and tips for a safer procedure.

关键词： central venous catheter insertion Iatrogenic Subclavian Artery Injury Viabahn Stent Graft Endovascular Treatment Surgical Techniques

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Thoracic duct cannulation during left internal jugular vein cannulation:A case report

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World Journal of Clinical Cases 2023年第34期11卷 8200-8204页

作者： Geal Hong Hwang Woosik Eom Department of Anesthesiology and Pain Medicine National Cancer CenterGoyang-si 10408Gyeonggi-doSouth Korea

BACKGROUND central venous catheter insertion is an invasive procedure that can cause complications such as infection,embolization due to air or blood clots,pneumothorax,hemothorax,and,rarely,chylothorax due to damage to the thoracic ***,we report a case of suspected thoracic duct cannulation that occurred during left central venous catheter ***,the patient was discharged without any adverse events related to thoracic duct *** SUMMARY A 46-year-old female patient presented at our department to undergo cytoreductive surgery and hyperthermic intraperitoneal *** anesthesia,we decided to insert a central venous catheter through the left internal jugular vein because the patient already had a chemoport through the right central *** the procedure,blood reflux was observed when the needle tip was not within the ultrasound field of *** did not try to find the tip;however,a guide wire and a central venous catheter were inserted without any ***,when inducing blood reflux from the distal port of the central venous catheter,only clear fluid,suspected to be lymphatic fluid,was ***,chest X-ray revealed an appearance similar to that of the path of the thoracic *** that intravenous fluid administration was not started and no abnormal fluid collection was noted on preoperative chest X-ray,we suspected thoracic duct *** It is important to use ultrasound to confirm the exact position of the needle tip and guide wire path.

关键词： central venous catheter insertion Left internal jugular vein Thoracic duct Lymph Ultrasound Case report

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