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Chirurgie 18. Juni 2013

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.

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