Inadvertent insertion of dialysis catheter into subclavian artery treated with a covered stent: A case report

IF 1.3 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2025-01-16 DOI:10.1002/ams2.70038
Yohei Takenobu, Akihiro Furuta, Sumire Haga, Hiroshi Yukawa, Noriko Nomura, Mizuha Toyama, Akihiro Okada, Takeshi Kawauchi, Yukinori Terada, Manabu Inoue, Kenji Hashimoto
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Abstract

Background

When inserting central venous catheters, inadvertent injury of major vessels is a rare yet critical complication. Direct surgery is sometimes overly invasive. This report describes a subclavian artery injury caused by inadvertent cannulation of a dialysis catheter, successfully treated with a covered stent.

Case Presentation

An 82-year-old woman with acute renal failure due to sepsis required emergency dialysis. During the insertion of a 12-Fr dialysis catheter into the right jugular vein, pulsatile reflux was noted. Computed tomography revealed catheter misplacement in the subclavian artery. Considering the patient's fragility, endovascular repair was performed. After embolization of side branches, a GORE VIABAHN stentgraft was delivered using a pull-through technique and deployed to seal the injury site. The patient was discharged without neurological or vascular complications.

Conclusion

Covered stents offer an effective solution for major vessel injuries requiring immediate hemostasis, particularly when direct surgery is complicated by underlying medical or anatomical conditions.

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带膜支架治疗锁骨下动脉透析导管误插入1例。
背景:在中心静脉置管时,大血管的意外损伤是一种罕见但重要的并发症。直接手术有时过于侵入性。本报告描述了一个锁骨下动脉损伤引起的疏忽插管透析导管,成功地治疗与覆盖支架。病例介绍:一名82岁妇女因败血症引起的急性肾功能衰竭需要紧急透析。在将12-Fr透析导管插入右颈静脉时,发现搏动性反流。计算机断层扫描显示锁骨下动脉导管错位。考虑到患者的脆弱性,我们进行了血管内修复。侧支栓塞后,采用拉通技术植入GORE VIABAHN支架,并封闭损伤部位。患者出院时无神经或血管并发症。结论:覆盖支架为需要立即止血的大血管损伤提供了有效的解决方案,特别是当直接手术因潜在的医学或解剖条件而合并时。
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来源期刊
Acute Medicine & Surgery
Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-
自引率
12.50%
发文量
87
审稿时长
53 weeks
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