Published in:
01-01-2004 | Clinical Investigations
Managing Inadvertent Arterial Catheterization During Central
Venous Access Procedures
Authors:
Tony Nicholson, Duncan Ettles, Graham Robinson
Published in:
CardioVascular and Interventional Radiology
|
Issue 1/2004
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Abstract
Purpose: Approximately 200,000 central
venous catheterizations are carried out annually in the National Health
Service in the United Kingdom. Inadvertent arterial puncture occurs in
up to 3.7%. Significant morbidity and death has been reported. We
report on our experience in the endovascular treatment of this
iatrogenic complication.
Methods: Retrospective analysis
was carried out of 9 cases referred for endovascular treatment of
inadvertent arterial puncture during central venous catheterization
over a 5 year period.
Results: It was not possible to
obtain accurate figures on the numbers of central venous
catheterizations carried out during the time period. Five
patients were referred with carotid or subclavian pseudoaneurysms and
hemothorax following inadvertent arterial catheter insertion and
subsequent removal. These patients all underwent percutaneous balloon
tamponade and/or stent-graft insertion. More recently 4 patients were
referred with the catheter still in situ and were successfully treated
with a percutaneous closure device.
Conclusion: If
inadvertent arterial catheterization during central venous access
procedures is recognized and catheters removed, sequelae can be treated
percutaneously. However, once the complication is recognized it is
better to leave the catheter in situ and seal the artery percutaneously
with a closure device.