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A 38-year-old woman experienced complications following endoscopic retrograde cholangiopancreatography, in the form of gallbladder perforation and extensive thoracic surgical emphysema. As part of her critical care management, she required a central venous catheter. Unfortunately, accidental cannulation of the left subclavian artery occurred during the procedure, which was confirmed through CT imaging with angiography of the thorax (figures 1 and 2, online supplemental video 1). There was no evidence of haemothorax on imaging. The patient was referred to our team for consideration of a minimally invasive solution, to circumvent the need for surgical repair. After reviewing the CT images, a decision was made to deploy an Angio-Seal vascular closure device (VCD) within 24 hours of the unfortunate cannulation (figure 3, online supplemental videos 2–5). Iatrogenic subclavian artery cannulation can occur as a complication of central venous catheterisation, with incidence …
Contributors RERS: Data collection and analysis and drafting of manuscript. KSI, RNK, JRI and AWU: Drafting of manuscript and revision of manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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