Utilizing a Percutaneous Sutured-Mediated Closure Device (Perclose Pro Glide) to Manage Iatrogenic Carotid Injury during Central Catheter Insertion: A Single Center's Experience

Case Presentation: Central venous catheter (CVC) insertion is a common procedure in hospitalized patients. Several side effects have been reported with this “blind” procedure without ultrasound, including pneumothorax, air embolism, misplacement and bleeding. Arterial injuries are among the most serious complications as they can lead to life-threatening complications if not treated. Possible treatments include manual compression, open surgical repair, and endovascular therapy. Hemostasis may not be easily achieved with manual compression especially with large catheter Fr size (7 Fr equivalent and above). Moreover, invasiveness of the procedure and significant blood loss during open surgery are the main disadvantages of this approach and Endovascular use of covered stent grafts in the subclavian artery (SCA) and carotid artery carries the risk of vertebral artery occlusion and postprocedure stroke and death, respectively. Recently, percutaneous arterial closure devices have been used to treat injured vessels and showed their effectiveness and safety. We presented a 76-year-old male with accidental carotid catheterization during central venous catheter insertion. 11Fr Catheter was removed and right carotid-Jugular fistula closed Utilizing 2 percutaneous sutured mediated closure devices. Final carotid angiogram showed complete resolution of the fistula. Subsequent cerebral angio showed excellent flow to the brain without any occlusion or absent flow. No immediate complications were encountered.

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Artikel online veröffentlicht:
02. April 2024