An unusual case of iatrogenic central venous injury

Author:

Singh Vishal1ORCID,Dabas Ajay Kumar2ORCID,Singh Pulkit3ORCID,S Sreenivasa1ORCID,Dogra Pavitra Manu1ORCID,Ghosh Indranil1

Affiliation:

1. Department of Nephrology Army Hospital (Research & Referral), Delhi Cantt Delhi India

2. Department of Vascular Surgery Army Hospital (Research & Referral), Delhi Cantt Delhi India

3. MS Ramaiah Medical College Bangalore India

Abstract

AbstractCentral venous catheter (CVC) provides ready vascular access and is widely used for the performance of hemodialysis. The use of CVC is associated with many complications and one life‐threatening complication is central venous injury. We describe an unusual case of central venous injury in a 69‐year‐old lady with a poorly functioning left internal jugular vein catheter, which was in situ at the time of attempting insertion of a replacement right internal jugular catheter. The management included initial stabilization, urgent hemodialysis, imaging, and an endovascular approach to mitigate the iatrogenic venous injury. The case highlights many learning points. The operator needs to be vigilant for anatomical abnormalities like stenosis in patients who have had previous CVC. In those with central venous perforation, the CVC should be left in situ till a definitive management plan is formulated. An endovascular approach, when feasible, is a minimally invasive effective management strategy.

Publisher

Wiley

Subject

Nephrology

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