Journal Article

An unusual route taken by a central venous catheter resulting in inadvertent subclavian artery cannulation: a case report

Angela Yun June Tan, Diana Xin Hui Chan and Chai Rick Soh

in Oxford Medical Case Reports

Volume 2015, issue 6, pages 303-305

Published online June 2015 | e-ISSN: 2053-8855 | DOI: https://dx.doi.org/10.1093/omcr/omv042

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Ultrasound-guided cannulation of a central venous catheter into the internal jugular vein (IJV) was performed in the intensive care unit for a critically ill patient. The catheter was inserted into the subclavian artery distally, despite prior ultrasound confirmation of the guidewire position using both the in-plane and out-of-plane views. The catheter was removed successfully by the interventional radiologist with a closure device. To our knowledge, there have been previous case reports of subclavian artery injury during IJV cannulation with ultrasound guidance, but rarely in the setting whereby the guidewire was visualized before dilatation and railroading of the catheter. This case demonstrates that the confirmation of the guidewire in the proximal segment of the vein is insufficient to exclude arterial cannulation.

Journal Article.  1036 words.  Illustrated.

Subjects: Critical Care

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