Central venous catheterisation (CVC) is a technique commonly used to obtain vascular access and over five million CVCs are inserted annually. This systematic review of CVC-related arterial injury aims to compare outcomes reported with different management strategies.
Methods
PRISMA guidelines were followed. A search of Medline, Embase, Central and CINAHL was performed. Results were limited to papers in humans and in English with duplicates removed. Details of cases including site and nature of arterial injury, use of ultrasound, methods for identifying arterial placement, management methods used, and any reported outcomes were collated from all papers. Successful management was defined as control of haemorrhage without evidence of further complications.
Results
We screened 2187 abstracts and 78 full manuscripts were obtained and reviewed. Twenty-four papers were of relevance and were included in this review. Amongst the papers, 80 cases of arterial injury were reported. Successful treatment by removal and compression, endovascular methods, and open surgical repair were 5.6%, 94.6% and 100%, respectively.
Discussion
Removal and compression of the arterial site is a poor management method and is associated with a high rate of complications. Endovascular approaches had a high rate of success with advantages of endovascular techniques including access to arteries which are difficult to expose surgically and avoidance of general anaesthesia. Endovascular repair might be considered depending on site of injury or local expertise though surgical repair reported the best results in this review with no complications seen.
The National Institute for Health and Care Excellence. Guidance on the use of ultrasound locating devices for placing central venous catheters.Available from: https://www.nice.org.uk/guidance/ta49. Accessed August 2, 2016.
2.
Raad I. Intravascular-catheter-related infections.Lancet19983519106893–898
3.
UrbanTWapplerFSakkaSG[Intra-arterial ECG leads of a positive P-wave potential during central venous catheterization].Anasthesiol Intensivmed Notfallmed Schmerzther201146294–97
4.
NicholsonTEttlesDRobinsonGManaging inadvertent arterial catheterization during central venous access procedures.Cardiovasc Intervent Radiol200427121–25
5.
GuilbertMCElkouriSBraccoDet al.Arterial trauma during central venous catheter insertion: Case series, review and proposed algorithm.J Vasc Surg2008484918–925discussion 925.
6.
KirkwoodMLWahlgrenCMDesaiTRThe use of arterial closure devices for incidental arterial injury.Vasc Endovascular Surg2008425471–476
7.
du ToitDFCoolenDLambrechtsAde V OdendaalJWarrenBLThe endovascular management of penetrating carotid artery injuries: long-term follow-up.Eur J Vasc Endovasc Surg2009383267–272
8.
AkkanKCindilEKilicKIlgitEOnalBErbasGMisplaced central venous catheter in the vertebral artery: endovascular treatment of foreseen hemorrhage during catheter withdrawal.J Vasc Access2014155418–423
BecharaCFBarshesNRPisimisisGKougiasPLinPHManagement of inadvertent carotid artery sheath insertion during central venous catheter placement.JAMA Surg2013148111063–1066
11.
DrollKPLossingAGCarotid-jugular arteriovenous fistula: case report of an iatrogenic complication following internal jugular vein catheterization.J Clin Anesth2004162127–129
12.
GongYXuHXLinMGuYAn iatrogenic complication of internal jugular vein catheterization for hemodialysis.Ir J Med Sci20121811135–137
13.
HerrmannJWFranzRWShahKJEndovascular repair of concomitant vertebral artery and subclavian artery iatrogenic perforations.Ann Vasc Surg2015294838.e17–838.e20
14.
HoLSpangerMHaywardPMcNicolLWeinbergLMissed carotid artery cannulation: a line crossed and lessons learnt.Anaesth Intensive Care2014426793–800
15.
JeganathVMcElwaineJGStewartPRuptured superior thyroid artery from central vein cannulation: treatment by coil embolization.Br J Anaesth2001872302–305
16.
KaitzisDGBalitasAGSkandalosIKHatzibaloglouAKCarotid artery repair after erroneous insertion of a hemodialysis catheter: case report.J Vasc Access200673136–138
17.
LiangHTCTAP C-071 Rescue of iatrogenic vertebral artery cannulation - endovascular treatment for misplaced central venous catheter in the vertebral artery.J Am Coll Cardiol20156517_SS192–S194
18.
MaiettaPMAccidental carotid artery catheterization during attempted central venous catheter placement: a case report.AANA J2012804251–255
19.
MollerSMLogasonKKarasonSThorissonHMPercutaneous thrombin injection of common carotid artery pseudoaneurysm without cerebral protection.Tex Heart Inst J2012395696–698
PowersCJZomorodiARBritzGWEnterlineDSMillerMJSmithTPEndovascular management of inadvertent brachiocephalic arterial catheterization.J Neurosurg20111141146–152
24.
PuaUTanGWPunamiyaSUse of StarClose Device under Ultrasound Guidance in Inadvertent Carotid Artery Puncture.J Vasc Interv Radiol20152691410–1412
25.
ReuberMDunkleyLATurtonEPBellMDBamfordJMStroke after internal jugular venous cannulation.Acta Neurol Scand20021053235–239
26.
SakanSBaronicaRBasic-JukicNStern-PadovanRTonkovicDRespiratory arrest due to hematoma caused by thyreocervical trunk branch laceration and confluence of sinuses perforation.J Vasc Access2012132259–262
27.
ShahPMBabuSCGoyalAMateoRBMaddenREArterial misplacement of large-caliber cannulas during jugular vein catheterization: case for surgical management.J Am Coll Surg20041986939–944
28.
WadhwaRTomsJNandaAAbreoKCuellarHAngioplasty and stenting of a jugular-carotid fistula resulting from the inadvertent placement of a hemodialysis catheter: case report and review of literature.Semin Dial2012254460–463
29.
BrassPHellmichMKolodziejLSchickGSmithAFUltrasound guidance versus anatomical landmarks for internal jugular vein catheterization.Cochrane Database Syst Rev20151CD006962
30.
American College of Emergency Physicians.American College of Emergency Physicians. ACEP emergency ultrasound guidelines-2001. Ann Emerg Med2001384470–481
31.
JankovicRJPavlovicMSStojanovicMMet al.Risk factors associated with carotid artery puncture following landmark-guided internal jugular vein cannulation attempts.Med Princ Pract2011206562–566
32.
IshizukaMNagataHTakagiKKubotaKRight internal jugular vein is recommended for central venous catheterization.J Invest Surg2010232110–114
33.
KhouzamRNSoufiMKWeatherlyMHeparin infusion through a central line misplaced in the carotid artery leading to hemorrhagic stroke.J Emerg Med2013453e87–e89
34.
BowdleAVascular complications of central venous catheter placement: evidence-based methods for prevention and treatment.J Cardiothorac Vasc Anesth2014282358–368
35.
MussaFFTowfighSRoweVLMajorKHoodDBWeaverFACurrent trends in the management of iatrogenic cervical carotid artery injuries.Vasc Endovascular Surg2006405354–361
36.
SchützNDollSBonviniRFErroneous placement of central venous catheter in the subclavian artery: retrieval and successful hemostasis with a femoral closure device.Catheter Cardiovasc Interv2011771154–157
37.
PikwerAAcostaSKölbelTMalinaMSonessonBAkesonJManagement of inadvertent arterial catheterisation associated with central venous access procedures.Eur J Vasc Endovasc Surg2009386707–714
