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Inadvertent arterial placement of central venous catheter: salvage using endovascular treatment
Manish Shaw1, Sheragaru Hanumanthappa Chandrashekhara2, Arun Sharma1
1CVR & EI, All India Institute of Medical Sciences, New Delhi, India.
Insights
Central venous catheter (CVC) placement in emergencies can lead to inadvertent subclavian artery (SCA) insertion. This case demonstrates successful endovascular management using a covered stent graft for misplaced CVC in the SCA.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Emergency Medicine
Background:
- Central venous catheter (CVC) use is increasing, often in emergency settings for venous access.
- Unintended subclavian artery (SCA) cannulation can occur during CVC placement without imaging guidance.
Observation:
- An unusual case of CVC inadvertently placed into the left SCA is presented.
- The patient required immediate intervention for this critical complication.
Findings:
- Successful endovascular management of the misplaced CVC in the SCA was achieved.
- A covered stent graft was utilized to repair the arterial wall and secure the catheter's position.
Implications:
- This case highlights a rare but serious complication of CVC insertion.
- Endovascular techniques, specifically covered stent grafts, offer a viable solution for managing inadvertent arterial placement of CVCs.
Abstract:
The frequency of placing a central venous catheter (CVC) has increased and it is often performed in emergency situation for venous access. During such an emergency and placing without imaging guidance, sometimes inadvertent placement of CVC in subclavian artery (SCA) can occur. We hereby describe an unusual case of successful endovascular management of inadvertently inserted CVC in SCA by covered stent graft placement along with proper clinical context to manage a case of misplaced venous catheter in left SCA.
