Vascular access challenge on a patient with cerebral palsy and severe kyphoscoliosis

J Vasc Access. 2010 Jan-Mar;11(1):66-8. doi: 10.1177/112972981001100114.

Abstract

We report a case of vascular assess challenge on a patient with severe kyphoscoliosis and joint contractures. Multiple internal jugular (IJ) central venous catheters (CVC) and a peripherally inserted central catheter (PICC) catheterization were attempted via ultrasound guidance and all resulted in malposition. The PICC attempt fortuitously pushed a malpositioned IJ into the correct position. Computed tomography (CT) demonstrated a narrow thoracic inlet with no definite venous stenoses. Therefore, severe chest wall deformity, a narrow thoracic inlet and inadequate positioning of the patient secondary to his contractures all contributed to the malposition of the PICC and CVCs.

Publication types

  • Case Reports

MeSH terms

  • Catheterization, Central Venous / adverse effects*
  • Cerebral Palsy / complications*
  • Cerebral Palsy / diagnostic imaging
  • Humans
  • Jugular Veins
  • Kyphosis / complications*
  • Kyphosis / diagnostic imaging
  • Male
  • Patient Positioning
  • Scoliosis / complications*
  • Scoliosis / diagnostic imaging
  • Severity of Illness Index
  • Subclavian Vein
  • Thoracic Wall / abnormalities
  • Tomography, X-Ray Computed
  • Ultrasonography, Interventional
  • Young Adult