Managing inadvertent arterial catheterization during central venous access procedures

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Device Technology

Background:

• Central venous catheterization is a common procedure with a risk of inadvertent arterial puncture.
• This complication can lead to significant morbidity and mortality.
• Endovascular treatment offers a minimally invasive approach to manage these iatrogenic injuries.

Purpose of the Study:

• To report on the experience of endovascular treatment for inadvertent arterial puncture during central venous catheterization.
• To evaluate the effectiveness of percutaneous techniques in managing this complication.

Main Methods:

• Retrospective analysis of 9 cases over a 5-year period.
• Cases involved inadvertent arterial puncture during central venous catheterization.
• Treatment modalities included percutaneous balloon tamponade, stent-graft insertion, and percutaneous closure devices.

Main Results:

• Five patients presented with pseudoaneurysms and hemothorax after catheter removal, treated with balloon tamponade and/or stent-grafts.
• Four patients with the catheter in situ were successfully treated with percutaneous closure devices.
• Accurate figures on catheterization numbers were unavailable, but the study highlights successful endovascular interventions.

Conclusions:

• Percutaneous treatment is effective for sequelae of inadvertent arterial catheterization if recognized and catheters are removed.
• For recognized complications, leaving the catheter in situ and sealing the artery percutaneously with a closure device is the preferred approach.