Wolfe Thomas J, Smith Tony P, Alexander Michael J, Zaidat Osama O
Department of Neurology, Medical College of Wisconsin/Froedtert Hospital, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Neurocrit Care. 2007;6(2):113-6. doi: 10.1007/s12028-007-0016-x.
Inadvertent arterial cannulation at a noncompressible site is a highly risky complication of central venous line placement.
We present a case of inadvertent placement of a 6-French venous sheath into the right subclavian artery (SCA) at the origin of the vertebral artery (VA), which was treated successfully using endovascular therapy.
Due to the complex site of cannulation, and the patient being fully anticoagulated, the use of a percutaneous closure device was not attempted. Open vascular surgery was not a treatment option due to high surgical risk. After determining left VA dominance, the right VA was occluded distal to the catheter entry point with platinum coils. Subsequently, a covered stent was placed into the SCA across the origin of the VA. The sheath was then removed safely without complications. A minor leak was initially present, which was stopped by repeating balloon inflation within the stent above nominal pressure.
在不可压缩部位意外进行动脉插管是中心静脉置管的一种高风险并发症。
我们报告一例在椎动脉（VA）起始处将6F静脉鞘意外置入右锁骨下动脉（SCA）的病例，该病例通过血管内治疗成功治愈。
由于插管部位复杂，且患者处于充分抗凝状态，未尝试使用经皮闭合装置。由于手术风险高，开放血管手术也不是一种治疗选择。在确定左侧椎动脉优势后，用铂金线圈在导管进入点远端闭塞右侧椎动脉。随后，在锁骨下动脉跨越椎动脉起始处放置一个覆膜支架。然后安全地取出鞘管，未出现并发症。最初有轻微渗漏，通过在支架内高于标称压力重复球囊扩张得以止住。
