Fatal outcome of jugular vein cannulation

We describe the case of a woman who had cannulation of the internal jugular vein for the placement of a hemodialysis catheter. The procedure was unsuccessful and resulted in a retropharyngeal hematoma, which in turn caused severe compression on a carotid artery that was already severely narrowed by atherosclerosis. This resulted in massive cerebral hemispheric infarction and death. During the course of hospitalization, ultrasonography, computed tomography, and angiographic studies were done. Cannulation of neck vessels in patients with bleeding diatheses must be done with caution, especially in the presence of severe stenotic disease of the carotid arteries.