Inadvertent subclavian artery cannulation treated by percutaneous closure

José E. Cohen*, J. Moshe Gomori, Haim Anner, Eyal Itshayek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Accidental arterial puncture occurs in around 1% and 2.7% of jugular and subclavian approaches, respectively. When a line has been inadvertently inserted into an artery at a noncompressible site, there is an increased risk for serious complications. This complication can be treated by either surgical or endovascular intervention or a combination; however, in critically ill patients or in those with impaired coagulation, therapeutic options are more limited. We describe successful endovascular management of inadvertent subclavian artery cannulation during insertion of a triple lumen central line catheter in a 35-year-old man suffering from leukemia, with sepsis and multi-organ failure. He was hypotensive and hemodynamically unstable, with severe coagulopathy. The catheter had entered the artery at the level of the origin of the internal mammary artery, just above the origin of the vertebral artery. The tip was lying in the aortic arch. The artery was successfully closed by endovascular deployment of an 8 French Angio-Seal device (St. Jude Medical, St. Paul, MN, USA). The device is licensed for use in femoral arterial puncture sites but provided safe and effective closure of the subclavian artery puncture in our patient.

Original languageEnglish
Pages (from-to)1973-1975
Number of pages3
JournalJournal of Clinical Neuroscience
Volume21
Issue number11
DOIs
StatePublished - 1 Nov 2014
Externally publishedYes

Keywords

  • Hemorrhage
  • Iatrogenic cannulation
  • Stent graft
  • Subclavian artery
  • Vascular closure device

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