Abstract:
Background: Internal jugular veins are the most frequently accessed site for central venous catheterization in patient management, whereas complications involving vertebral veins are a rare occurrence.
Case: A 73-year-old male suspected to have a urothelial carcinoma was scheduled for elective left nephroureterectomy. During central venous catheterization using the anatomic landmark technique to target the internal jugular vein, a guidewire is inadvertently inserted into the suspected vertebral vein. Following the correction of the catheterization, a radiologist reviewed the preoperative enhanced computed tomography and confirmed that the initially punctured vessel was the vertebral vein. On the third day after surgery, the central venous catheter was removed, and the patient did not exhibit any complications, such as bleeding, swelling, and neurological symptoms.
Conclusions: The use of ultrasonography during central venous catheterization is recommended to evaluate the anatomy of the puncture site and prevent misinsertion of the catheter, which can lead to several complications.
Reference:Lee J, Suh J, Oh J, Ki S. Guidewire insertion into the vertebral vein during right internal jugular vein central venous catheterization -A rare case report. Anesth Pain Med (Seoul). 2023 Oct;18(4):382-388. doi: 10.17085/apm.23052. Epub 2023 Oct 10. PMID: 37919922.