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Managing inadvertent arterial catheterization during central venous access procedures
Tony Nicholson1, Duncan Ettles, Graham Robinson
1Department of Vascular Radiology, Hull and East Yorkshire Hospitals Trust, Anlaby Road, Hull HU3 2JZ, UK. Tony.Nicholson@leedsth.nhs.uk
Cardiovascular and Interventional Radiology
|April 28, 2004
Summary
Endovascular techniques can effectively treat inadvertent arterial puncture during central venous catheterization. Leaving the catheter in place and using a percutaneous closure device is recommended for recognized complications.
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.