Inadvertent aortic arch cannulation complicated by stroke

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Accidental arterial cannulation during central venous catheter insertion is a serious complication that is associated with a high risk of vascular and neurologic complications” Othman et al (2017).

Extract:

Accidental arterial cannulation during central venous catheter insertion is a serious complication that is associated with a high risk of vascular and neurologic complications. Herein, we describe a case of inadvertent aortic arch cannulation complicated by stroke. The catheter was removed successfully using an Angio-Seal closure device.

A 59-year-old nursing home resident presented to our hospital with septic shock. The patient had a deformity of his upper chest from a prior motor vehicle accident and thoracic surgery. A left subclavian triple-lumen catheter was placed in the emergency room for fluid resuscitation. Subsequent hemodynamic monitoring via this catheter revealed an arterial wave, leading to suspicion of iatrogenic cannulation of the left subclavian artery. Review of the chest x-ray showed coiling of the catheter in the area of the aortic arch.

Reference:

Othman, H., Rosman, H., Saravolatz, L. and Rama, K. (2017) Aortic Cannulation: An Unexpected Complication of Central Venous Catheter Placement. Journal of Cardiothoracic and Vascular Anesthesia. February 4th. [epub ahead of print].

http://doi.org/10.1053/j.jvca.2017.02.021

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