Volume 4 Supplement 1
Mediastinic perforation by hemodialysys catheter during the procedure. A case report.
© Pinilla et al; licensee Springer. 2012
Published: 18 December 2012
Keywordscentral venous catheters vascular perforation mechanical complications
We present the case of a patient, 60 years old, which has been carrying multiple central venous catheters for hemodialysis. We recived consultation: the patient need a central vascular access. He has malfunctioning of femoral dialysis catheter, central catheter in left internal jugular vein removed a week ago, the right jugulosubclavian territory with thrombosis.
We try cannulation of left internal jugular vein, with ultrasound and radiologic guidance.
During the procedure, the patient experienced sudden and intense chest pain, which disappear spontaneously in a few seconds. At the end of the procedure one of the catheter´s lights was malfunctioning. Before starting hemodialysis the chest pain is reproduced by serum injection. Rx appropriate check. Chest CT is performed and it shown the vascular perforation. The patient suffer mediastinic perforation due to catheter of 14'5F, into the left brachiocephalic vein. The vascular perforation is in the same area of permcath kink previous.
Several mechanical complications associated with central venous catheters, even using ultrasonography and radiology during the procedure, are reported.
It is essential to have a high index of suspicion in patients with known vascular diseases, carriers of thick catheters for long periods, especially left approaches. This creates particular vulnerability to serious complications as vascular perforation.
- Merrer J, Lefrant JY, Timsit JF: How to improve central venous catheter use in intensive care unit? Ann Fr Anesth Reanim 2006,25(2):180–8. 10.1016/j.annfar.2005.07.079PubMedView ArticleGoogle Scholar
- Martínez A, López LA, Rodríguez JM, Cacho E, Pueyo FJ, Monedero P: Mediastinitis tardía con hidrotórax bilateral tras perforación vascular por catéter venoso central. Rev.Esp. Anestesiol. Reanim 2005, 52: 634–636.Google Scholar
- Banerjee A, Bhowmick K, Nayagam M, Farrington K: Late atrial perforation from tunnelled haemodialysis catheter. QJMed 2010, 103: 527–529. 10.1093/qjmed/hcp195View ArticleGoogle Scholar
- Kotsikoris I, Zygomalas A, Papas T, Maras D, Pavlidis P, Andrikopoulou M, Tsanis A, Alivizatos V, Bessias N: Insertion of central venous catheters for hemodialisis using angiographic techniques in patients with previous multiple catheterizations. Eur J Radiol 2012,81(9):2270–2272. 10.1016/j.ejrad.2011.06.025PubMedView ArticleGoogle Scholar
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