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[Inadvertent arterial misplacement of a large-caliber cannula during jugular vein catheterization]

Kenji Tamai1, Yoshihiro Hirabayashi, Atsuko Tomita

  • 1Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Shimotsuke 329-0498.

Masui. the Japanese Journal of Anesthesiology
|June 22, 2010
PubMed

Insights

During jugular vein catheterization, a large cannula was mistakenly placed in the brachiocephalic trunk. This case highlights the subclavian artery trauma risk during this common procedure.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Anesthesiology

Background:

  • Central venous catheterization, particularly via the internal jugular vein, is a common procedure.
  • Potential complications include arterial injury, though typically rare.
  • Anatomical variations and cannula size can influence risk.

Observation:

  • A 9F cannula was inadvertently advanced into the brachiocephalic trunk through the subclavian artery during attempted jugular vein catheterization.
  • The arterial misplacement was identified and managed promptly.
  • The management involved cannula removal and external compression.

Findings:

  • The case demonstrates a significant risk of subclavian artery trauma during jugular vein catheterization.
  • Large-caliber cannula use may increase this risk.
  • Successful management of arterial misplacement is possible with prompt recognition and intervention.

Implications:

  • Clinicians should be aware of the subclavian artery's proximity and potential for excursion during jugular catheterization.
  • Careful technique and anatomical consideration are crucial to prevent arterial injury.
  • This emphasizes the need for vigilance and preparedness for managing vascular complications during central line placement.

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