Successful removal of a central venous catheter misplaced in the right subclavian artery using an intravascular stent: a case report

Abstract

Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

Extravascular Central Venous Line Removal and Endovascular Covered Stent Implantation Guided by 3-Dimensional Computed Tomographic Reconstruction

“… 2 However, removal of a misplaced catheter without consideration of the implications (eg, uncontrolled bleeding from the entry/exit sites) without pre-procedural planning can result in haemodynamic compromise, as manual pressure application after catheter removal may not achieve haemostasis. 3 Endovascular covered stent implantation is a less invasive approach to address the perforated vessel and provides an alternative when surgical repair is challenging due to anatomy or patient clinical instability. Pre-procedural 3D image reconstruction is a tool to provide an understanding of the relationships of cardiac structures and, in this case, detailed venous anatomy to guide the intervention.…”