Inadvertent subclavian artery catheter placement complicated by stroke: endovascular management and review

Catheter Cardiovasc Interv. 2009 Apr 1;73(5):706-11. doi: 10.1002/ccd.21884.

Abstract

Background: Removal of large-bore venous catheters misplaced within the subclavian artery risks significant hemorrhage due to the noncompressible entry site. Comorbidities in these patients often make traditional surgical approaches prohibitive.

Case description: We present a case of inadvertent subclavian artery placement of a central venous catheter complicated by thromboembolic stroke, illustrate treatment with a combination of percutaneous closure and temporary balloon tamponade, and review the endovascular management of this unusual problem.

Conclusion: Endovascular treatment of inadvertent subclavian artery catheterization appears to be a reasonable option, and its less-invasive nature may be beneficial for patients in whom the underlying disease initially required central venous access.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiography, Digital Subtraction
  • Anticoagulants / therapeutic use
  • Balloon Occlusion* / instrumentation
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Catheters, Indwelling / adverse effects*
  • Cerebral Angiography
  • Device Removal
  • Diffusion Magnetic Resonance Imaging
  • Hemorrhage / etiology
  • Hemorrhage / pathology
  • Hemorrhage / therapy*
  • Hemostatic Techniques* / instrumentation
  • Heparin / therapeutic use
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Punctures
  • Radiography, Interventional
  • Stroke / etiology*
  • Stroke / pathology
  • Stroke / therapy
  • Subclavian Artery / injuries*
  • Subclavian Artery / pathology
  • Thromboembolism / etiology*
  • Thromboembolism / pathology
  • Thromboembolism / therapy
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin