Dialysis Catheter Placement via the Left Internal Jugular Vein: Risk of Brachiocephalic Vein Perforation

Autor: Marc R. Scheltinga, Michiel B. Winkes, Maarten J. A. Loos, Joep A.W. Teijink
Přispěvatelé: MUMC+: MA AIOS Heelkunde (9), Epidemiologie, RS: CARIM School for Cardiovascular Diseases, RS: CARIM - R3.08 - Regenerative and reconstructive medicine for vascular disease
Rok vydání: 2016
Předmět:
Male
Brachiocephalic vein
Catheterization
Central Venous
medicine.medical_specialty
Computed Tomography Angiography
medicine.medical_treatment
Perforation (oil well)
030232 urology & nephrology
030204 cardiovascular system & hematology
Radiography
Interventional
03 medical and health sciences
Catheters
Indwelling
0302 clinical medicine
Device removal
Renal Dialysis
Risk Factors
Central Venous Catheters
Humans
Medicine
Internal jugular vein
Device Removal
Ultrasonography
Interventional
Tesio (R) catheters
Brachiocephalic Veins
Computed tomography angiography
Aged
80 and over
Perforation
Left internal jugular vein
medicine.diagnostic_test
business.industry
Suture Techniques
Central venous catheter insertion
Hemodynamics
Equipment Design
Phlebography
Dialysis catheter
Vascular System Injuries
Sternotomy
Treatment Outcome
Regional Blood Flow
Nephrology
Kidney Failure
Chronic
Surgery
Radiology
Jugular Veins
business
Central venous catheter
Zdroj: Journal of vascular access, 17(4), E75-E78. SAGE Publications Ltd
ISSN: 1724-6032
1129-7298
Popis: Purpose We discuss a case of a brachiocephalic vein (BCV) perforation after Tesio® central venous catheter insertion. Method and Results An 80-year-old patient underwent an ultrasound-guided hemodialysis (HD) catheter placement via his left internal jugular vein (IJV). One day postoperatively, the patient became hemodynamically unstable immediately after HD initiation. As a vascular event was feared, an emergency CT scan was performed demonstrating a BCV perforation. The patient underwent a sternotomy, the lines were removed and the venous laceration was closed. The patient recovered well. Conclusions In spite of ultrasound guidance, fluoroscopy for guidewire and sheath advancement, venous blood aspiration and a normal appearing postoperative x-ray, traumatic central venous catheter placement is still possible. Tenting of the BCV wall during catheter advancement possibly caused the venous perforation. A ‘how-to’ for correct catheter placement via the IJV is provided and potential pitfalls during each procedural step are discussed.
Databáze: OpenAIRE
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