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Iatrogenic subclavian artery pseudoaneurysms: case reports.
B K Brzowski1, J L Mills, W C Beckett
1Vascular Surgery Service, SGHSG, USAF Medical Center, Lackland AFB, Texas 78236-5300.
The Journal of Trauma
|May 1, 1990
Summary
Iatrogenic subclavian artery pseudoaneurysms are rare complications of subclavian vein cannulation, particularly in hypovolemic patients. Prompt arteriography and primary repair are crucial for managing these injuries.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Patient Safety
Background:
- Subclavian vein cannulation is a common procedure for central venous access.
- Iatrogenic arterial injuries can occur during central venous catheterization.
- The use of invasive monitoring and diagnostic techniques is increasing.
Observation:
- Two cases of iatrogenic subclavian artery pseudoaneurysms are presented.
- These pseudoaneurysms resulted from inadvertent introducer sheath placement during attempted subclavian vein cannulation.
- Both patients were in hypovolemic shock at the time of the procedure.
Findings:
- Preoperative arteriography confirmed the arterial injuries in both cases.
- Primary arterial repair was successfully performed in both patients.
- Iatrogenic subclavian artery pseudoaneurysms are rare but potentially serious complications.
Implications:
- Avoid subclavian vein cannulation with large-bore catheters in hypovolemic patients.
- Arteriography is recommended for evaluating suspected iatrogenic arterial injuries.
- Primary repair of confirmed injuries is essential to prevent thrombosis, rupture, or embolization.