CVC insertion related lymphatic injury
Abstract:
Lymphatic injury and chylothorax are known, albeit rare, complications of both right and left internal jugular central venous catheter placement.[1] [2] Some reports suggest that these complications occur more frequently when lines are placed in the presence of other complicating factors such as infection or thrombosis.[3] [4] [5] [6] [7] [8] Although rare, the potential for a peripheral lymphatic injury is present during vascular access adjacent to the inguinal nodal cluster. A case of iatrogenic peripheral lymphatic injury during placement of a femoral tunneled central venous catheter (TCVC) is described. We review peripheral lymphatic anatomy, suggest approaches to avoid inadvertent lymphatic injury, and discuss management strategies of a peripheral lymphatic injury.
Reference:
Rzewnicki D, Loya MF, Charles H, Kokabi N, Nezami N, Majdalany BS. Lymphorrhea following Tunneled Femoral Central Venous Catheter Placement: Avoidance and Management of a Rare Complication. Semin Intervent Radiol. 2022 Dec 20;39(5):533-536. doi: 10.1055/s-0042-1757943. PMID: 36561932; PMCID: PMC9767775.