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Managing iatrogenic subclavian artery cannulation using a vascular closure device: a minimally invasive option
  1. RE Raja Shariff,
  2. KS Ibrahim,
  3. RN Khir,
  4. JR Ismail,
  5. AW Undok
  1. Cardiology Unit, Department of Internal Medicine, UiTM Kampus Sungai Buloh, Sungai Buloh, Malaysia
  1. Correspondence to Dr RE Raja Shariff, UiTM Kampus Sungai Buloh, Sungai Buloh 47000 Selangor, Malaysia; rajaezman{at}gmail.com

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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 …

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Footnotes

  • 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.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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