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.

Mini-invasive treatment of a large pseudoaneurysm of the neck related to central venous catheter placement: A case report

Palermo, Chiara;Sanfiorenzo, Angelo;Giaquinta, Alessia;Veroux, Massimiliano
Writing – Review & Editing
;
Veroux, Pierfrancesco
2018

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.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/360860
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