Cuhaci B, Khoury P, Chvala R
Department of Medicine, Hahnemann Hospital, MCP/Hahnemann University, Philadelphia, PA 19129, USA.
Am J Nephrol. 2000 Nov-Dec;20(6):476-82. doi: 10.1159/000046203.
Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following reports of an increased incidence of subclavian vein stenosis due to subclavian vein catheterization. Internal jugular vein catheterization is associated with a high rate of successful catheter placement. However, significant complications such as internal carotid artery (ICA) puncture, pneumothorax, vessel erosion, thrombosis, airway obstruction and infection can occur. The most common complication is ICA puncture. More recently a few cases of thyrocervical trunk pseudoaneurysm and fistula following internal jugular vein and subclavian vein catheterization attempts have been reported. Patients with renal failure who are on hemodialysis may have to undergo multiple catheter placements and vascular access interventions. This, along with their comorbid conditions, increases the risk of such complications. Here we report a patient on hemodialysis who developed transverse cervical artery pseudoaneurysm following an attempted right internal jugular vein catheterization. We report this case because of its rarity, to raise awareness of such a complication and to discuss different treatment options, in particular endovascular coil occlusion. A review of relevant literature is also presented.
由于锁骨下静脉置管导致锁骨下静脉狭窄的发生率增加，颈内静脉置管已成为临时血液透析导管置入的首选方法。颈内静脉置管的导管置入成功率很高。然而，可能会出现严重并发症，如颈内动脉（ICA）穿刺、气胸、血管侵蚀、血栓形成、气道阻塞和感染。最常见的并发症是ICA穿刺。最近，有报道称在尝试颈内静脉和锁骨下静脉置管后出现了几例甲状腺颈干假性动脉瘤和瘘管。接受血液透析的肾衰竭患者可能需要多次进行导管置入和血管通路干预。这与他们的合并症一起，增加了此类并发症的风险。在此，我们报告一名接受血液透析的患者，在尝试右颈内静脉置管后发生了颈横动脉假性动脉瘤。我们报告这一病例是因其罕见性，以提高对此类并发症的认识，并讨论不同的治疗选择，特别是血管内线圈闭塞术。同时还对相关文献进行了综述。
