Related Experiment Video

Updated: Aug 12, 2026

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
07:41

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

2.4K

Brachiocephalic Vein Perforation During Cannulation of Internal Jugular Vein: A Case Report

Atsushi Kainuma1, Keiichi Oshima, Chiho Ota

  • 1From the Departments of *Anesthesiology and Critical Care, †Thoracic Surgery and ‡Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; and §Department of Anesthesiology, JSDF Hanshin Hospital, Kawanishi, Hyogo, Japan.

A & a Case Reports
|June 17, 2017
PubMed

Insights

A rare complication occurred during internal jugular vein cannulation: brachiocephalic vein perforation. Tortuous carotid arteries can displace the jugular vein, leading to guidewire misplacement and potential vessel injury.

Area of Science:

  • Vascular Surgery
  • Anesthesiology
  • Medical Imaging

Background:

  • Ultrasound-guided internal jugular vein (IJV) cannulation is a common procedure.
  • Anatomical variations, such as a tortuous common carotid artery (CCA), can complicate IJV access.
  • Proper guidewire manipulation is crucial for safe central venous catheterization.

Observation:

  • A rare case of right brachiocephalic vein perforation during right IJV cannulation is presented.
  • The patient had a tortuous common carotid artery, suspected to displace the IJV.
  • A J-tip guidewire was misplaced into the subclavian vein, leading to perforation by the dilator sheath.

Findings:

  • Massive hemothorax was diagnosed via videothoracoscopy.
  • The perforation resulted from guidewire malposition secondary to anatomical variation.
  • This highlights a potential risk during IJV catheterization in patients with tortuous CCAs.

Implications:

  • Anesthesiologists must consider the risk of guidewire malposition in patients with tortuous CCAs.
  • Awareness of this complication can improve patient safety during central venous access procedures.
  • Further studies may explore specific techniques to mitigate this risk in challenging anatomies.

More Related Videos

Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein05:51

Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein

Published on: January 13, 2026

241
Author Spotlight: Improved Imaging for Neovascular Development in Congenital Heart Disease Research07:53

Author Spotlight: Improved Imaging for Neovascular Development in Congenital Heart Disease Research

Published on: April 26, 2024

1.1K

Related Concept Videos

Veins of Head and Neck01:19

Veins of Head and Neck

The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
Veins of Upper Limbs01:17

Veins of Upper Limbs

The human circulatory system, a marvel of biological engineering, is a complex network of vessels that transport blood throughout the body. Among these, the veins responsible for carrying blood from the upper limbs are divided into two categories: deep and superficial.
The deep venous system is primarily composed of the ulnar and radial veins. The ulnar vein, which drains the fingers through the superficial palmar venous arches, and the radial vein, which serves the palms via the deep palmar...
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...