Open AccessManagement of inadvertent vertebral artery injury due to central venous catheterization in a coagulopathic patient
Author(s) -
Yamamoto Akitaka,
Suzuki Kei,
Sakaida Hiroshi,
Suzuki Hidenori,
Imai Hiroshi
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.177
Subject(s) - medicine , vertebral artery , surgery , embolization , coagulopathy , arteriovenous fistula , catheter , radiology , internal jugular vein , jugular vein , basilic vein , interventional radiology , cyanoacrylate , chemistry , adhesive , organic chemistry , layer (electronics)
Case A 72‐year‐old man was admitted to the intensive care unit for severe pancreatitis with coagulopathy. He underwent hemodialysis catheter insertion into the internal jugular vein that subsequently leaked arterial blood; vertebral artery cannulation was suspected following a computed tomography scan. Outcome Under angiographic guidance, the catheter was removed, and an arteriovenous fistula was identified. The patient was successfully treated with endovascular embolization of the affected vertebral artery with detachable coils and N ‐butyl‐2‐cyanoacrylate. Conclusion Despite ultrasound guidance, vertebral cannulation can occur, which can result in serious complications. Prompt management is needed to prevent further sequelae. Endovascular embolization with detachable coils and N ‐butyl‐2‐cyanoacrylate appears to be an effective option for vertebral artery injury in patients with coagulopathy.