Mini-invasive treatment of a large pseudoaneurysm of the neck related to central venous catheter placement: A case report. Issue 29 (July 2018)

• Record Type: Journal Article
• Authors: Palermo, Chiara; Sanfiorenzo, Angelo; Giaquinta, Alessia Testo; Virgilo, Carla; Veroux, Massimiliano; Veroux, Pierfrancesco
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 29(2018)
• Publication Date: 2018-07
• Subjects: central venous catheter -- complications -- endovascular repair -- pseudoaneurysm -- stent-graft -- thyro-cervical trunk -- thyroid artery; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000011262
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Central venous catheter (CVC) placement, particularly in emergency setting, may be associated with significant morbidity and mortality. Patient concerns: A 33-year old woman with suspected pulmonary embolism, developed a pseudoaneurysm of the neck three days after a CVC placement in the right internal jugular vein, determining compression to adjacent neck structures. Diagnoses: Computed tomography angiography and selective angiography demonstrated the presence of the pseudoaneurysm originating from the thyro-cervical trunk. Interventions: The treatment was minimally invasive with endovascular exclusion first, and an open thrombectomy to resolve compressive syndrome two days later. Outcomes: The color Doppler ultrasound confirmed the complete exclusion of the pseudoaneurysm with patency of the thyroid artery. A comprehensive review of literature on the risk factors and management of the unintended artery puncture was included. Lessons: A correct technique under ultrasound guidance may reduce the incidence of unintended arterial injury during CVC placement. In patients with suitable anatomy and unfit for open repair, a minimally invasive approach provides a safe alternative to open surgery with excellent results.