Fatal arterial complications following ultrasound-guided attempt of internal jugular vein catheterization
Background: Puncture of the posterior venous wall during ultrasound-guided internal jugular vein cannulation seems to be common, making underlying artery at risk of injury.
Methods: Two cases of injury through the posterior wall of the internal jugular vein and an injury to the underlying artery are reported.
Results: In case number 1, a small injury of the carotid arterial wall resulted in a retrograde dissection of the common carotid artery and ascending part of the aorta, causing a fatal cardiac tamponade—a sequence of events never previously described. In case number 2, an unexpected injury to the thyrocervical trunk in a severely thrombocytopenic patient caused an extensive hematoma that compromised the upper airway, eventually leading to a fatal outcome.
Conclusion: These two reported fatal arterial complications during ultrasound-guided cannulation of the internal jugular vein add to other publications of complications after central vein catheterization. It is important to increase awareness of these avoidable serious complications.