Iatrogenic catheter sheath shearing during radial artery cannulation

Kim, Il-Seok; Shin, Ho Kyun; Kim, Dae Yu

doi:10.4097/kjae.2013.65.6s.s12

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…While embolization of fragments of central venous, 5 arterial, 6 and peripheral venous catheters 3 are well known, we did not find reports of an angiocatheter fragmentation during CVC insertion as described here. The exact explanation of this failure remains uncertain, but we speculate that 5 possible mechanisms could account for the observed event:…”

Section: Discussioncontrasting

confidence: 69%

Management of a Fragmented Angiocatheter During Central Venous Cannulation: A Case Report and Important Lessons

John

Sripada²,

Prielipp³

2021

A&A Practice

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Complications during central venous catheter (CVC) insertion are infrequent with an incidence of 0.1%–1%. We experienced a rare CVC complication with fragmentation of the angiocatheter at its hub during central venous cannulation while utilizing the modified Seldinger technique (ie, wire through the catheter technique). Vascular surgery was emergently required to remove the catheter fragment from the neck. Clinicians must remain vigilant during all aspects of CVC insertion, including awareness of the potential for fragmentation of the angiocatheter during its removal over the in situ guidewire. Prompt recognition and appropriate management included leaving the guidewire in place (to stabilize the distal fragmented segment) and promptly consulting vascular surgery for removal before potential vascular embolization of the angiocatheter fragment. We further recommend that all components of the insertion kit be inspected before and after patient use.

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Section: Discussioncontrasting

confidence: 69%

Management of a Fragmented Angiocatheter During Central Venous Cannulation: A Case Report and Important Lessons

John

Sripada²,

Prielipp³

2021

A&A Practice

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“…It is exceedingly rare for a portion of the catheter to dislodge or shear off. Indeed, these are such rare events, that their occurrence warrants reporting and often results in publication as case reports [ 5 , 7 , 14 - 16 ]. It is not possible to be certain about the cause of the catheter shearing, but most clinicians suspect that the shearing occurs during difficult placement of the catheter that results in catheter trauma.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Transection of Radial Arterial Catheter Requiring Surgical Intervention

Tollinche

Jackson

et al. 2018

J Intensive Crit Care

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We report a case in which a radial arterial line was placed prior to induction of general anaesthesia in a 76 year old male with prostate cancer and multiple co-morbidities who presented for thoracoscopic resection of a right lower lobe carcinoid lung tumor. The patient’s intra-operative course was complicated by acute blood loss requiring conversion to an open procedure. A subsequent injury to the superior vena cava resulted in the need for immediate re-exploration at the conclusion of surgery. While the arterial line was still indicated in this patient’s postoperative course in the ICU, malfunction on post-operative day one resulted in removal of the catheter. The catheter was secured by stay sutures and during the attempt to cut these sutures, the arterial catheter was inadvertently severed and a fragment remained within the patient’s radial artery. Surgical intervention was required to remove the retained catheter and the patient recovered without evidence of residual injury or deficit to the artery and extremity. Literature review reveals only one other case report of a retained catheter in a radial artery caused by accidental transection during removal. We review indications for arterial line placement, complications, as well as methods for securing arterial catheters.

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“…Nevertheless, it is important to note that reinsertion of any of the needles back into the catheter should be avoided given the potential risk for shearing the catheter. 4 Further study in a clinical setting will be required to determine whether the tactile sensation experienced by clinician would be similar with the new design.…”

mentioning

confidence: 99%

A modified Tuohy needle tip design for catheter over needle catheterization: in vitro testing

Tsui

2021

Can J Anesth/J Can Anesth

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Iatrogenic catheter sheath shearing during radial artery cannulation

Cited by 5 publications

References 4 publications

Management of a Fragmented Angiocatheter During Central Venous Cannulation: A Case Report and Important Lessons

Management of a Fragmented Angiocatheter During Central Venous Cannulation: A Case Report and Important Lessons

Case Report: Transection of Radial Arterial Catheter Requiring Surgical Intervention

A modified Tuohy needle tip design for catheter over needle catheterization: in vitro testing

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