Unexpected complication of arteriovenous fistula of the left common carotid to internal jugular vein following central venous catheterization
10.1016/j.cjtee.2019.10.001
- VernacularTitle:Unexpected complication of arteriovenous fistula of the left common carotid to internal jugular vein following central venous catheterization
- Author:
Henry Tan Chor Lip
1
,
2
;
Tan Huei JIH
;
Mohamad YUZAIDI
;
Suryani Lenny SAFRI
;
K. KRISHNA
;
Alwi Imran RIZAL
;
Azim Md Idris Mohamad
;
Hanafiah HARUNARASHID
Author Information
1. Trauma Surgery Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
2. Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
- Keywords:
Artery;
Cannulation;
Arterio-venous fistula;
Ultrasound
- From:
Chinese Journal of Traumatology
2020;23(1):29-31
- CountryChina
- Language:Chinese
-
Abstract:
Incidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation.
