Central venous catheter (CVC) insertion with ultrasound guidance is routine clinical practice in the critically ill patient. Arterial malposition is serious and may lead to severe complications such as hemorrhage, stroke, or death. We describe a bail-out technique for removal of right-sided CVC that was mispositioned into the brachiocephalic trunk (BCT) at the origin of the right common carotid artery (CCA). Covered stenting of the BCT extending into the CCA in combination with plug embolization of the right subclavian artery was utilized.
GuilbertMElkouriSBraccoD, et al.Arterial trauma during central venous catheter insertion: case series, review and proposed algorithm. J Vasc Surg. 2008;48(4):918–925. doi:10.1016/j.jvs.2008.04.046
3.
MainlandPTamWLawBKeeW. Stroke following central venous cannulation. Lancet. 1997;349(9056):921. doi:10.1016/s0140-6736(97)24013-4
4.
PikwerAAcostaSKölbelTMalinaMSonessonBÅkesonJ. Management of inadvertent arterial catheterisation associated with central venous access procedures. J Vasc Surg. 2009;50(6):1529. doi:10.1016/j.jvs.2009.10.054
5.
JonkerFIndesJMollFMuhsB. Management of iatrogenic injuries of the supra-aortic arteries. J Cardiothorac Vasc Anesth. 2010;24(2):322–329. doi:10.1053/j.jvca.2009.09.004
6.
RoldanCPaniaguaL.Central venous catheter intravascular malpositioning: causes, prevention, diagnosis, and correction. West J Emerg Med. 2015;16(5):658–664. doi:10.5811/westjem.2015.7.26248
7.
BismuthJGrayBHoldenAMetzgerCPannetonJ. Pivotal study of a next-generation balloon-expandable stent-graft for treatment of iliac occlusive disease. J Endovasc Ther. 2017;24(5):629–637. doi:10.1177/1526602817720463
8.
BecharaCAnnambhotlaSLinP. Access site management with vascular closure devices for percutaneous transarterial procedures. J Vasc Surg. 2010;52(6):1682–1696. doi:10.1016/j.jvs.2010.04.079
