Biomaterial Database

Endovascular treatment of inadvertent cannulation of the vertebro-subclavian arterial junction. 2007

Thomas J Wolfe, and Tony P Smith, and Michael J Alexander, and Osama O Zaidat

Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.

BACKGROUND Inadvertent arterial cannulation at a noncompressible site is a highly risky complication of central venous line placement. METHODS We present a case of inadvertent placement of a 6-French venous sheath into the right subclavian artery (SCA) at the origin of the vertebral artery (VA), which was treated successfully using endovascular therapy. RESULTS Due to the complex site of cannulation, and the patient being fully anticoagulated, the use of a percutaneous closure device was not attempted. Open vascular surgery was not a treatment option due to high surgical risk. After determining left VA dominance, the right VA was occluded distal to the catheter entry point with platinum coils. Subsequently, a covered stent was placed into the SCA across the origin of the VA. The sheath was then removed safely without complications. A minor leak was initially present, which was stopped by repeating balloon inflation within the stent above nominal pressure.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D002405	Catheterization, Central Venous	Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein.	Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D004621	Embolization, Therapeutic	A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.	Embolotherapy,Therapeutic Embolization,Embolizations, Therapeutic,Embolotherapies,Therapeutic Embolizations
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D013348	Subclavian Artery	Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.	Arteries, Subclavian,Artery, Subclavian,Subclavian Arteries
D014711	Vertebral Artery	The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.	Vertebral Arteries,Arteries, Vertebral,Artery, Vertebral
D014950	Wounds, Penetrating	Wounds caused by objects penetrating the skin.	Penetrating Wound,Penetrating Wounds,Wound, Penetrating
D015607	Stents	Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.	Stent
D017130	Angioplasty	Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.	Angioplasty, Transluminal,Endoluminal Repair,Percutaneous Transluminal Angioplasty,Angioplasties,Angioplasty, Percutaneous Transluminal,Endoluminal Repairs,Repair, Endoluminal,Repairs, Endoluminal,Transluminal Angioplasty,Transluminal Angioplasty, Percutaneous