A case report of an accidental vertebral arterial puncture videotaped during central venous catheterization in a child undergoing a ventricular septal defect repair

Section: Discussionmentioning

confidence: 99%

Position and relative size of the vertebral artery according to age: Implications for internal jugular vein access

Jung

Jalilov

Song

et al. 2017

“…Therefore, the vein is often deliberately penetrated (to aspirate blood), and this places the VAs at risk of puncture in a small group of infants. In cases in which the VAs are near the IJVs, using the ultrasonogram as a guide, the puncture needle should not be advanced toward the VAs ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic analysis of the anatomical relationships between vertebral arteries and internal jugular veins in children

Kayashima

Ueki

Kinoshita

2012

Self Cite

BackgroundAccidental puncture of the vertebral arteries (VAs) can occur through the internal jugular veins (IJVs) during central venous catheterization (CVC). We evaluated the anatomic relation of the VAs to the IJVs in children undergoing IJV cannulation.MethodsFifty-five patients were placed in the supine position under general anesthesia. The right IJV, common carotid artery (CCA), and VA were described with an ultrasound probe perpendicular to all planes of the skin at the mid-portion between the suprasternal notch and mastoid process. The depth from the skin to VAs (D), width of the VAs (W), and distance from the IJVs to VAs (DIV) were measured. The extent of overlap between the IJVs and VAs was classified into overlapping, partially overlapping, and nonoverlapping. The risk was scored as 0–3 for each measurement. The scores were added and categorized into a low-risk group (L), 0–3, moderate-risk (M) group, 4–7; and high-risk (H) group, 8–10.ResultsMean (sd) age was 20.3 (33.9) months, height was 72.1 (26.0) cm, and weight was 8.9 (9.0) kg. The mean D, W, and DIV were 15.1 (3.3), 2.8 (1.1), and 4.6 (1.8) mm, respectively. Of the 55 patients, 7 were in group H, 33 in group M, and 15 in group L.ConclusionsSeven of the 55 children were categorized under the H group for accidental puncture of the VAs. Thus, it is important to identify the presence of the VAs to avoid accidental puncture during pediatric CVC.

“…An accidental vertebral arterial puncture was reported during central venous catheterization in a child undergoing ventricular septal defect repair (9). Vertebral arteries are seen behind the IJV to a certain extent (10).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound detection of guidewires in‐plane during pediatric central venous catheterization

Kayashima

Imai

Sozen

2012

Self Cite