Minimally invasive approach to managing brachiocephalic trunk cannulation complicating central venous catheterization: a case report
Dublin Core
Title
Minimally invasive approach to managing brachiocephalic trunk cannulation complicating central venous catheterization: a case report
Subject
Central venous catheterization, Brachiocephalic trunk, Cannulation, Catheter replacement
Description
Abstract
Background Central venous catheterization, crucial for device insertion, monitoring, medication, and fluid
resuscitation, commonly uses the subclavian, internal jugular, and femoral veins. Despite its general safety,
complications like arterial puncture can be life-threatening, requiring rapid diagnosis and treatment.
Case presentation A 74-year-old woman in the recovery phase of cerebral infarction underwent right subclavian
vein catheterization. The catheter was mistakenly placed in the brachiocephalic trunk, with its tip in the ascending
aorta, as confirmed by computed tomography (CT) and digital subtraction angiography (DSA). With the high
surgical risk and the complexity of endovascular treatment, catheter replacement was chosen. One month after the
initial placement, the catheter was replaced with a smaller one, and another month later, it was retracted without
complications. Follow-up CT and DSA revealed no leakage, with the patient’s vitals remaining stable. A three-month
post-discharge phone follow-up confirmed the patient’s continued stability.
Conclusion This case demonstrates the effective use of a catheter replacement technique as a minimally invasive
repair method when other options are impractical. Ultrasound guidance is also recommended to improve the
procedure’s accuracy and safety.
Keywords Central venous catheterization, Brachiocephalic trunk, Cannulation, Catheter replacement
Background Central venous catheterization, crucial for device insertion, monitoring, medication, and fluid
resuscitation, commonly uses the subclavian, internal jugular, and femoral veins. Despite its general safety,
complications like arterial puncture can be life-threatening, requiring rapid diagnosis and treatment.
Case presentation A 74-year-old woman in the recovery phase of cerebral infarction underwent right subclavian
vein catheterization. The catheter was mistakenly placed in the brachiocephalic trunk, with its tip in the ascending
aorta, as confirmed by computed tomography (CT) and digital subtraction angiography (DSA). With the high
surgical risk and the complexity of endovascular treatment, catheter replacement was chosen. One month after the
initial placement, the catheter was replaced with a smaller one, and another month later, it was retracted without
complications. Follow-up CT and DSA revealed no leakage, with the patient’s vitals remaining stable. A three-month
post-discharge phone follow-up confirmed the patient’s continued stability.
Conclusion This case demonstrates the effective use of a catheter replacement technique as a minimally invasive
repair method when other options are impractical. Ultrasound guidance is also recommended to improve the
procedure’s accuracy and safety.
Keywords Central venous catheterization, Brachiocephalic trunk, Cannulation, Catheter replacement
Creator
Haihui Deng1
, Bin Chen1
, Deti Peng2
and Fuwen Pang1*
, Bin Chen1
, Deti Peng2
and Fuwen Pang1*
Source
https://doi.org/10.1186/s12245-024-00744-9
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Haihui Deng1
, Bin Chen1
, Deti Peng2
and Fuwen Pang1*, “Minimally invasive approach to managing brachiocephalic trunk cannulation complicating central venous catheterization: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12505.