The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Percutaneous Suture-Based Closure Device for Management of Inadvertent Subclavian Artery Catheterization

실수로 설치된 쇄골하동맥 카테터에 대한 경피적 혈관 봉합 매개기구 이용

  • Lee, Seong Soo (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ko, Jaehoon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Kyung-Suk (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Beomsu (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Ga Yeon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Seung-Hyuk (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 이성수 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 고재훈 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 임경숙 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 신범수 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 이가연 (성균관대학교 의과대학 삼성서울병원 내과학교실) ;
  • 최승혁 (성균관대학교 의과대학 삼성서울병원 내과학교실)
  • Received : 2013.08.08
  • Accepted : 2013.09.05
  • Published : 2014.08.01
⟨ Previous Next ⟩

Abstract

Central venous catheterization is performed to secure pathways for large amounts of saline, drug infusion, parenteral nutrition support, and hemodialysis. Accidental subclavian artery cannulation is a possible complication of central venous catheterization. Here, we report two cases of 8 Fr. chemoports inadvertently inserted in subclavian arteries during internal jugular venous catheterizations. The chemoports were removed successfully, and puncture sites were repaired using suture-based closure devices (Perclose). One patient experienced minor neurological complications after the procedure. With effective management, the patient was treated with no sequelae. To our knowledge, this is the first report of stroke after procedures using suture-based devices.

저자들은 쇄골하동맥을 통해 케모포트가 실수로 삽입된 상태에서 $Perclose^{(R)}$를 이용하여 성공적으로 혈관봉합을 한 두 증례에 대해 보고하였다. 중심정맥관 삽입 시 발생할 수 있는 잘못된 쇄골하동맥 천자 및 도관 삽입에 대하여 봉합-매개 혈관폐쇄기구를 이용한 경피적 혈관봉합은 효과적인 지혈 방법으로 고려될 수 있으며 한편으로 혈색전에 의한 뇌졸중 발생을 염두에 두고 시술 중에 주의가 필요하다.

Keywords

References

  1. Nicholson T, Ettles D, Robinson G. Managing inadvertent arterial catheterization during central venous access procedures. Cardiovasc Intervent Radiol 2004;27:21-25.
  2. Shetty SV, Kwolek CJ, Garasic JM. Percutaneous closure after inadvertent subclavian artery cannulation. Catheter Cardiovasc Interv 2007;69:1050-1052. https://doi.org/10.1002/ccd.21143
  3. Fraizer MC, Chu WW, Gudjonsson T, Wolff MR. Use of a percutaneous vascular suture device for closure of an inadvertent subclavian artery puncture. Catheter Cardiovasc Interv 2003;59:369-371. https://doi.org/10.1002/ccd.10545
  4. Becker GJ, Benenati JF, Zemel G, et al. Percutaneous placement of a balloon-expandable intraluminal graft for life-threatening subclavian arterial hemorrhage. J Vasc Interv Radiol 1991;2:225-229. https://doi.org/10.1016/S1051-0443(91)72286-0
  5. Jahromi BS, Tummala RP, Levy EI. Inadvertent subclavian artery catheter placement complicated by stroke: endovascular management and review. Catheter Cardiovasc Interv 2009;73:706-711. https://doi.org/10.1002/ccd.21884
  6. Millward SF, Lamb MN, Barron PT. Use of a balloon catheter to control hemorrhage from the subclavian artery after removal of an inadvertently placed catheter. AJR Am J Roentgenol 1991;156:1261-1262. https://doi.org/10.2214/ajr.156.6.2028874
  7. Yu H, Stavas JM, Dixon RG, Burke CT, Mauro MA. Temporary balloon tamponade for managing subclavian arterial injury by inadvertent central venous catheter placement. J Vasc Interv Radiol 2011;22:654-659. https://doi.org/10.1016/j.jvir.2011.03.010
  8. Wallace MJ, Ahrar K. Percutaneous closure of a subclavian artery injury after inadvertent catheterization. J Vasc Interv Radiol 2001;12:1227-1230. https://doi.org/10.1016/S1051-0443(07)61685-6
  9. Schoder M, Cejna M, Holzenbein T, et al. Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries. J Endovasc Ther 2003;10:58-65. https://doi.org/10.1583/1545-1550(2003)010<0058:EAEETO>2.0.CO;2
  10. Hon LQ, Ganeshan A, Thomas SM, Warakaulle D, Jagdish J, Uberoi R. Vascular closure devices: a comparative overview. Curr Probl Diagn Radiol 2009;38:33-43. https://doi.org/10.1067/j.cpradiol.2008.02.002