Vascular Erosion by Central Venous Catheters. Clinical Features and Outcome

Chest. 1992 Jun;101(6):1633-8. doi: 10.1378/chest.101.6.1633.

Abstract

We evaluated the clinical characteristics of eight patients who presented with vascular erosion from central venous catheters and reviewed the available literature. Patients typically presented with dyspnea or chest pain, unilateral or bilateral pleural effusions, and mediastinal widening one to seven days after catheter insertion. Pleural fluid appeared transudative with variable glucose concentrations (range, 174 to 588 mg/dl) that were always greater than concurrent serum values. Diagnosis was delayed 3.0 +/- 1.5 days (range, 0 to 11 days) after vascular erosion. One patient died and four patients received chest tubes. Seven of eight patients had left-sided line placement; six of these seven left-sided catheters abutted the superior vena cava wall within approximately 45 degrees of perpendicular. Results of a literature search confirm the hazards of delayed diagnosis and the importance of left-sided catheter placement as a risk factor for vascular erosion.

Publication types

  • Review

MeSH terms

  • Brachiocephalic Veins / injuries*
  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / instrumentation
  • Catheterization, Central Venous / statistics & numerical data
  • Critical Care / statistics & numerical data
  • Humans
  • Hydrothorax / diagnostic imaging
  • Hydrothorax / epidemiology
  • Hydrothorax / etiology
  • Incidence
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / epidemiology
  • Pleural Effusion / etiology
  • Radiography
  • Subclavian Vein / injuries*
  • Vena Cava, Superior / injuries*