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Management of arterial trauma during central venous catheter insertion using a percutaneous suture-mediated closure device (Perclose ProGlide): a report of two cases and literature review

  • Sultan AlSheikh1
  • Mohammed Yousef Aldossary1,2,*,
  • Rafat Najeeb1,3
  • Nasser Saleh Alwehaibi1,4
  • Kaisor Iqbal1

1Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, 11322 Riyadh, Saudi Arabia

2Division of Vascular Surgery, Department of Surgery, Dammam Medical Complex, 32245 Dammam, Saudi Arabia

3Division of Vascular Surgery, Department of Surgery, King Fahd Central Hospital, 82511 Jazan, Saudi Arabia

4Division of Vascular Surgery, Department of Surgery, King Fahad Specialist Hospital, 52535 Buraydah, Saudi Arabia

DOI: 10.22514/sv.2023.115 Vol.19,Issue 6,November 2023 pp.201-206

Submitted: 15 October 2022 Accepted: 13 December 2022

Published: 08 November 2023

*Corresponding Author(s): Mohammed Yousef Aldossary E-mail: Dr.Mohd.Aldossary@gmail.com

Abstract

We evaluated the safest approach to treat catheter-related cervicothoracic arterial injuries by reviewing two inadvertent arterial injury cases during central venous catheter insertion and their related complications at an intensive care unit. In the first case, C-arm angiography confirmed accidental catheter placement in the right subclavian artery (SCA). In the second case, accidental catheter placement in the right common carotid artery was confirmed via computed tomography angiography of the neck and chest. The catheter was connected to a high-pressure arterial bag in both cases. The Perclose ProGlide Suture-Mediated Closure System (Abbott Laboratories, IL, USA) was used and successfully operated the two cases of iatrogenic SCA and carotid artery injuries. A follow-up bedside ultrasound at 2 and 6 hours postoperatively revealed normal Doppler waveforms in the inadvertent arterial injury and distal arteries without hematoma at the puncture site in both cases. In conclusion, for inadvertent artery puncture, which occurs in <12% of jugular and subclavian venous procedures, the endovascular approach using a covered stent appears to be safe for treating the accidental catheter placement in the carotid artery, although some cases of post-procedure stroke have been reported. In this regard, the percutaneous arterial suture device (Perclose ProGlide) offers an almost 100% success rate and lowers morbidity and mortality rates compared with open surgical and endovascular approaches for treating iatrogenic SCA and carotid artery injuries. These two cases highlight the effectiveness of minimally invasive percutaneous arterial closure devices in treating this infrequent but potentially lethal injury.


Keywords

Inadvertent puncture; Central venous catheter; Percutaneous arterial closure device


Cite and Share

Sultan AlSheikh,Mohammed Yousef Aldossary,Rafat Najeeb,Nasser Saleh Alwehaibi,Kaisor Iqbal. Management of arterial trauma during central venous catheter insertion using a percutaneous suture-mediated closure device (Perclose ProGlide): a report of two cases and literature review. Signa Vitae. 2023. 19(6);201-206.

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