Central venous catheterization–induced right brachiocephalic vein pseudoaneurysm: Successfully treated with stent-assisted coiling

2018 ◽  
Vol 19 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Sun-Ju Choi ◽  
Young Woo Do ◽  
Tak-Hyuk Oh ◽  
Hoseok Lee ◽  
Hyejin Cheon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coil Embolization ◽  
Central Venous Catheterization ◽  
Treatment Options ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Central Venous ◽  
Mediastinal Hematoma ◽  
Venous Catheterization ◽  
The Right

Introduction: Central venous catheterization–induced central vein pseudoaneurysm is rare. Several treatment options have been recommended. We describe a case of central venous catheterization–induced right brachiocephalic vein pseudoaneurysm successfully treated with an uncovered self-expandable stent-assisted coil embolization and discuss the imaging findings, treatment strategy, and review of literature associated with thoracic venous pseudoaneurysm. Case report: A 77-year-old woman was referred to our trauma center to undergo treatment for central venous catheterization-induced central vein pseudoaneurysm. The initial contrast-enhanced chest computed tomography revealed a 3.4-cm pseudoaneurysm arising from the right brachiocephalic vein and a surrounding mediastinal hematoma. The pseudoaneurysm was successfully embolized with stent-assisted coiling. Computed tomography angiography was performed 10 days after the procedure and demonstrated a completely embolized pseudoaneurysm and resolved mediastinal hematoma. Blood flow from the right subclavian and left innominate veins was not disturbed by the stent-assisted coils. Conclusion: To our knowledge, this is the first report of treatment of a right brachiocephalic vein pseudoaneurysm with stent-assisted coil embolization. We think that uncovered stent-assisted coil embolization is the safest and most fundamental treatment for wide-neck venous pseudoaneurysm especially in a hemodynamically unstable setting.

Subaortic left brachiocephalic vein and real-time ultrasound-guided puncture

2021 ◽  
pp. 112972982110346
Author(s):  
Fernando Montes-Tapia ◽  
José Arenas-Ruiz ◽  
Rosa Palma-Soto ◽  
Zelenia Garcia-Alcudia ◽  
Claudia Yasbek Rodríguez-Garza ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Central Venous Catheterization ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Left Brachiocephalic Vein ◽  
Venous Catheterization ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture

We describe a subaortic left brachiocephalic vein, a congenital anomaly that can be suspected during the rapid central vein assessment before central venous catheterization. Since the vein descends vertically/obliquely rapidly from its origin, we suggest that the puncture should be made at a greater angle (50°–60°) than what is usually used to puncture this vein (20°–30°). Failure to identify this anomaly may cause a failed puncture or complications from the puncture of adjacent blood vessels.

Rapid Central Vein Assessment (RaCeVA): A systematic, standardized approach for ultrasound assessment before central venous catheterization

2018 ◽  
Vol 20 (3) ◽  
pp. 239-249 ◽  
Author(s):  
Timothy R Spencer ◽  
Mauro Pittiruti
Keyword(s):  
Vascular Access ◽  
Central Venous Catheterization ◽  
Central Vein ◽  
Arterial Cannulation ◽  
Central Venous ◽  
Anatomical Structures ◽  
Venous Catheterization ◽  
Ultrasound Technology ◽  
Ultrasound Assessment ◽  
Vascular Structures

Ultrasound technology has revolutionized the practice of safer vascular access, for both venous and arterial cannulation. The ability to visualize underlying structures of the chest, neck, and upper/lower extremities provides for greater success, speed, and safety with all vascular access procedures. Ultrasound not only yields superior procedural advantages but also provides a platform to perform a thorough assessment of the vascular structures to evaluate vessel health, viability, size, and patency, including the location of other important and best avoided anatomical structures—prior to performing any procedures. Such assessment is best performed using a systematic and standardized approach, as the Rapid Central Vein Assessment, described in this study.

scholarly journals Supraclavicular Approach Is an Easy and Safe Method of Subclavian Vein Catheterization Even in Mechanically Ventilated Patients

2009 ◽  
Vol 111 (2) ◽  
pp. 334-339 ◽  
Author(s):  
Tomasz Czarnik ◽  
Ryszard Gawda ◽  
Tadeusz Perkowski ◽  
Rafal Weron
Keyword(s):  
Confidence Interval ◽  
Complication Rate ◽  
Central Venous Catheterization ◽  
Central Venous ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Supraclavicular Approach ◽  
Venous Catheterization ◽  
The Right ◽  
Ventilated Patients

Background Central venous catheters are commonly inserted for hemodynamic monitoring, volume monitoring, administration of medications, long-term total parenteral nutrition, access for renal replacement therapy, cardiopulmonary resuscitation, and difficult peripheral catheterization. The primary outcome of this study was to define venipuncture, catheterization and entire procedure success rates, and finally complication rate of subclavian venous catheterization via the supraclavicular approach with special focus on mechanically ventilated patients. The secondary outcome was to potentially make recommendations regarding this technique of central venous catheterization in mechanically ventilated patients. Methods The methodology of this prospective cohort study included subclavian venous catheterization via the supraclavicular approach. The technique of cannulation was the same for both the right and left sides, but the right claviculosternocleidomastoid angle was the preferred catheterization site. All procedures were performed by the first three authors, each of whom had different levels of experience. Each physician had performed at least 20 procedures before starting the study. Results In the majority of patients, venipuncture occurred during the first attempt. In 362 patients, catheterization attempts were performed, in whom 311 catheterizations (85.6%) were successful during the first attempt. The overall subclavian venous catheterization via supraclavicular approach procedure complication rate reached 1.7% (95% confidence interval 0.6-3.6%). The overall subclavian venous catheterization via the supraclavicular approach procedure success rate reached 88.9% (95% confidence interval 85.1-91.9%, n = 359). Conclusions Subclavian venous catheterization via the supraclavicular approach is an excellent method of central venous access in mechanically ventilated patients. The procedure success rate and the significant complication rate are comparable to other techniques of central venous catheterization.

scholarly journals Mediastinal malposition of catheter after venous cut down

2018 ◽  
Vol 5 (4) ◽  
pp. 1577
Author(s):  
Md. Imran Nasir ◽  
Rekha Gupta ◽  
Sanjay Gupta ◽  
A. K. Attri
Keyword(s):  
Central Venous Catheterization ◽  
Case Reports ◽  
Feeding Tube ◽  
Anterior Mediastinum ◽  
Critically Ill Patient ◽  
Central Vein ◽  
Basilic Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
Infant Feeding Tube

Central venous catheterization is one of the very essential tool of modern intensive care. Apart from monitoring the critically ill patient, it helps in administration of antibiotics, parenteral nutrition, chemotherapy, fluids and drug delivery. Peripheral inserted central catheter (PICC) by surgically isolating basilic vein or venous cut down, is considered one of the safe technique to access central veins. The advantage of this procedure is that traumatic complications like pneumothorax, hemothorax and arterial puncture are less as compared to directly placing central catheters. Malposition (intracaval or extracaval) is one of the commonly encountered complication associated with central venous catheterization. Extracaval is rarely encountered and there are isolated case reports in the literature where catheter tip is found outside the central vein into the surrounding structures. Knowledge of such complications is important else these remain unrecognized resulting in delayed treatment and poor outcome. Here, we report a unique case, wherein tip of infant feeding tube inserted from basilic vein was found in anterior mediastinum resulting bilateral hemothorax and pleural effusion.

Misplacement of a central venous catheter into azygos vein via the right internal jugular vein

2020 ◽  
pp. 112972982095099
Author(s):  
Minjia Wang ◽  
Liang Xu ◽  
Yue Feng ◽  
Shijin Gong
Keyword(s):  
Central Venous Catheter ◽  
Critically Ill Patients ◽  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Azygos Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
Tip Position ◽  
The Right

For critically ill patients, central venous catheterization may not always be placed in a correct tip position, even when guided by ultrasound. A case of inadvertent catheterization into azygos vein is described.

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