Inadvertent vertebral vein catheterisation during transjugular vein cannulation: a rare complication

Abstract

Sağ internal jugüler ven aracılığıyla santral venöz kanü-lasyon yaygın olarak kullanılan bir teknik olup, kateterin yerleştirilme aşaması, ilerletme aşaması ve çıkarılma aşa-ması gibi farklı aşamalarda komplikasyonlara yol açabilir. Santral venöz kateterin malpozisyonu, tehlikeli sonuçlara da yol açabilmektedir. Bu yazıda, kateterin çıkarılma aşa-masında fark edilen, santral venöz kateterin yedinci vertebral foramen içerisindeki sağ vertebral vene yanlışlıkla yerleştirildiği 74 yaşında erkek bir olgu sunuldu. Central venous cannulation through the right internal jugular vein, which is a widely used technique, may lead to complications at different stages, including catheter placement stage, indwelling stage and the removal stage. Malposition of the central venous catheter may also result in catastrophic consequences. In this article, we report 74-year-old male case with misplaced central venous catheter into the right vertebral vein in seventh vertebral foramen, which was detected at the catheter removal stage.

Guidewire insertion into the vertebral vein during right internal jugular vein central venous catheterization -A rare case report-

“…Furthermore, except for surgeries of the head and neck, most surgeries allow for easy access to the insertion site for anesthesiologists. However, approximately 15% of central venous catheterization cases result in complications, such as arterial puncture, pneumothorax, vessel erosion, thrombosis, occlusion, airway obstruction, malposition of the catheter tip, and delayed infection, with arterial puncture being the most common complication [ 1 , 3 ]. The malposition of the catheter tip occurs relatively commonly, at a rate of 5.01% [ 2 ].…”

“…Due to its relatively small size and deep course compared with the internal jugular vein, inadvertent catheterization of the vertebral vein during central venous access is a rare occurrence. However, there are a few case reports where this occurrence happened [ 1 , 2 , 4 , 5 ].…”

“…As practitioners of anesthesiology and pain medicine, we have frequently been required to access numerous veins; among the tools used to access these veins, the central venous catheter is a powerful and essential tool in patient management. Despite various benefits, central venous catheterization, especially when targeting the internal jugular vein, can lead to significant complications, such as common carotid artery puncture, pneumothorax, hematoma, arteriovenous fistula formation, venous infarction, catheter entrapment, and fluid leakage [ 1 , 2 ]. During surgical procedures, the internal jugular vein is the most frequently accessed site for central venous catheterization in patient management, whereas complications involving the vertebral vein are a rare occurrence.…”

Retrospective Investigation of Preference for Anatomical Localization and Malposition of Catheters in Patients with Central Venous Catheterization

“…Turan ve ark. [13] sağ İJV kanulasyonu sırasında kateterin yanlışlıkla servikal vertebra hizasından vertebral vene yerleştiğini tespit etmişler ve santral venöz kanülasyon sırasında kateterin küçük venöz damarlara da yerleşebileceğini belirtmişlerdir.…”

Accidental vertebral vein catheterization during internal jugular vein cannulation – A rare complication

“…In the sixth upper vertebrae, the transverse foramen gives passage to the vertebral artery and vein, whereas the seventh gives passage only to the vertebral vein. [3] Puncture of the vertebral artery adjacent to the vertebra vein is quite common, whereas puncture of the vertebral vein is quite rare, but it does happen. [4] As it lies posterior to the IJV, it is possible to pass the catheter into the vertebral vein if head is rotated excessively to more than 30° or if needle is inserted to more than 4-cm depth.…”