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. 2011 Apr;24(2):96-100.
doi: 10.1080/08998280.2011.11928692.

Iatrogenic Vertebral Artery Pseudoaneurysm Due to Central Venous Catheterization

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Free PMC article

Iatrogenic Vertebral Artery Pseudoaneurysm Due to Central Venous Catheterization

Janneth Momiy et al. Proc (Bayl Univ Med Cent). .
Free PMC article

Abstract

Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery pseudoaneurysm formation is one of the rarer complications of central line placement. Presented is a rare case of two pseudoaneurysms of the vertebral and subclavian artery after an attempted internal jugular vein catheterization. These were successfully treated with open surgical repair and bypass. Open surgical repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudoaneurysms has been described with promising outcomes, but long-term results are lacking. Ultimately, the best treatment of these iatrogenic injuries should start with prevention. Well-documented techniques to minimize mechanical complications, including inadvertent arterial puncture, should be practiced and taught in training programs to avoid the potentially devastating consequences.

Figures

Figure 1
Figure 1
CT angiogram of the chest and abdomen showing the hematoma over the right subclavian artery and vertebral artery.
Figure 2
Figure 2
CT angiogram of the chest and abdomen demonstrating (a) the vertebral artery pseudoaneurysm (arrow) and (b) the pseudoaneurysm of the subclavian artery distal to the vertebral artery takeoff (arrow).
Figure 3
Figure 3
Angiogram showing the vertebral artery and subclavian artery pseudoaneurysms.
Figure 4
Figure 4
Intraoperative picture of the pseudoaneurysm.
Figure 5
Figure 5
Postoperative follow-up CT angiogram showing the polytetrafluoroethylene bypass graft and patent vertebral and subclavian artery.

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