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"Retrieval of a misplaced CVC within a subclavian artery using the percutaneous closure device Angio-Seal™ is quite safe and effective" Verloh et al (2021).

Abstract:

Background: Retrospective evaluation of the safety and efficacy of the retrieval of misplaced central venous catheters (CVCs) in subclavian arteries using the femoral closure device Angio-Seal™.

Methods: The clinical data of five patients (female, n = 2; mean age, 55.0 years ± 11.9) in whom a misplaced CVC within a subclavian artery was removed followed by closure of the vessel entry site with 8-French (F) Angio-Seal™ was analyzed.

Results: In 4/5 patients (80%; CVC diameter, 7-8F) the procedure was technically successful without complications. In 1/5 patients (20%; CVC diameter, 11.5F) the procedure failed and an additional covered stent was placed for successful closure of the vessel entry site. There were no complications associated with the Angio-Seal™ or stent implantation during follow-up.

Conclusion: Retrieval of a misplaced CVC within a subclavian artery using the percutaneous closure device Angio-Seal™ is quite safe and effective; however, caution is required if there is a mismatch in the diameter of the Angio-Seal™ and CVC. In the case of procedure failure, successful closure of the vessel entry site can be achieved by covered stent placement.

Reference:

Verloh N, Scharf G, Bäumler W, Pfister K, Oikonomou K, Stroszczynski C, Uller W, Dollinger M. Erroneous placement of central venous catheters in subclavian artery: Retrieval and successful hemostasis with a femoral closure device. J Vasc Access. 2021 Apr 7:11297298211007704. doi: 10.1177/11297298211007704. Epub ahead of print. PMID: 33827311.