Related Experiment Video
Updated: Jan 7, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Percutaneous Arterial Closure for Inadvertent Subclavian Artery Cannulation During Central Venous Catheterization: A
1Department of Cardiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Insights
Arterial injury during central venous catheterization (CVC) can cause severe bleeding. Image-guided percutaneous suturing offers a safe and effective minimally invasive repair for these mild arterial injuries, ensuring patient recovery.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Critical Care Medicine
Background:
- Arterial injury is a rare but serious complication of central venous catheterization (CVC), occurring in 0.1%–2.7% of procedures.
- Complications include hemorrhage, occlusion, embolism, and pseudoaneurysm, posing significant risks, especially in critically ill patients on anticoagulation.
- Accidental left subclavian artery puncture during CVC in an 81-year-old woman with multiple comorbidities exemplifies the clinical challenge.
Purpose of the Study:
- To report a case of successful management of arterial injury during CVC.
- To highlight the efficacy of percutaneous arterial closure using image-guided vascular suturing.
- To emphasize the safety and benefits of this minimally invasive approach in complex patients.
Main Methods:
- Color Doppler ultrasonography assessed injury size and location.
- CT angiography evaluated surrounding vasculature for complications.
- Image-guided percutaneous vascular suturing with fluoroscopy and real-time contrast imaging was performed for repair.
Main Results:
- The arterial injury was successfully managed by catheter removal and percutaneous closure.
- The patient experienced an uneventful postoperative recovery with no pseudoaneurysm or arteriovenous fistula.
- Hemodynamics remained stable, and no further vascular complications were observed.
Conclusions:
- Percutaneous suturing is a safe and effective treatment for mild arterial injuries from CVC.
- This minimally invasive technique minimizes vascular trauma and prevents significant complications.
- It is particularly beneficial for patients with complex comorbidities requiring CVC.
Abstract:
BACKGROUND Arterial injury during central venous catheterization (CVC) occurs in 0.1% to 2.7% of cases and can lead to serious complications, such as arterial occlusion, embolism, pseudoaneurysm, vessel rupture, and life-threatening hemorrhage. These risks are particularly concerning in critically ill patients, especially those receiving anticoagulation or with acute coagulopathy. CASE REPORT We report the case of an 81-year-old woman with a complex medical history, including chronic heart failure, atrial fibrillation, chronic obstructive pulmonary disease (COPD), and chronic kidney disease, whose left subclavian artery was accidentally punctured during central venous catheterization (CVC). The injury was managed successfully by removing the catheter and performing percutaneous arterial closure. The repair involved image-guided percutaneous vascular suturing, using fluoroscopy and real-time contrast imaging. Before the procedure, color Doppler ultrasonography was used to assess the injury's size and location, while CT angiography evaluated the surrounding vasculature for complications, including arterial rupture or significant bleeding. The postoperative recovery was uneventful, with no signs of pseudoaneurysm or arteriovenous fistula. The patient maintained stable hemodynamics throughout the recovery period and exhibited no signs of further vascular complications. CONCLUSIONS Percutaneous suturing is a safe and effective method for managing mild arterial injuries during central venous catheterization (CVC), especially in patients with complex comorbidities. This approach provides precise hemostasis, minimizes vascular trauma, and offers a minimally invasive solution to prevent significant complications, ensuring a smooth recovery.
