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Santral Venöz Kateterizasyon Girişimi Sonrasında Gelişen Psödoanevrizma ve Endovasküler Tedavisi

Year 2021, Volume: 4 Issue: 4, 149 - 152, 29.12.2021
https://doi.org/10.54996/anatolianjem.1004014

Abstract

Amaç: Olgumuzda acil serviste internal juguler ven (IJV) kateterizasyonu sırasında arteriyal ponksiyona sekonder gelişen tiroservikal trunkus kaynaklı psödoanevrizma ve endovasküler tedavisi anlatılmakta olup amacımız nadir görülen bu komplikasyonun tanınması ve güvenli tedavisinin tartışılmasıdır.

Olgu: Acil servisimize başvuran 21 yaşında erkek hastaya acil diyaliz kararı alınmış. Geçici hemodiyaliz kateteri takılması amacıyla acil serviste sol IJV’den girişim denenmiş. İğne girişi sonrası gelen pulsatil kan nedeniyle iğne çekilmiş. Basıya rağmen boyunda hızlı büyüyen şişlik meydana gelen hasta radyoloji birimimize ileri inceleme amacıyla yönlendirildi. Birimimizde yapılan tetkikler sonucu tiroservikal trunkus kaynaklı psödoanevrizma teşhisi konuldu. Yapılan anjiografide koil embolizasyon ile endovasküler tedavisi tamamlandı.

Sonuç: IJV kateterizasyonu sonrasında boyunda üfürüm olsun veya olmasın şişlik gelişen hastalarda psödoanevrizmanın da akla gelmesi ve Doppler USG ile araştırılması gerekmektedir. Gelişen psödoanevrizmanın tedavisinde endovasküler koil embolizasyon güvenilir ve efektif bir yöntem olarak ilk planda tercih edilmelidir.

References

  • Siu YP, Tong MKh, Poon WL et al. Haemodialysis catheter-related right transverse cervical artery pseudoaneurysm and treatment by coil embolization. Nephrology 2005;10:37-9.
  • Cuhaci B, Khoury P, Chvala R. Transverse Cervical Artery Pseudoaneurysm: A Rare Complication of Internal Jugular Vein Cannulation. Am J Nephrol 2000;20:476-82.
  • Orak M, Üstündag M, Güloglu C et al. Factors that effect on complication development while inserting central venous catheter. Turk J Emerg Med 2006;6(2):51-55.
  • Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: internal jugular versus subclavian access a systematic review. Crit Care Med 2002;30:454-60.
  • Palermo, C, Sanfiorenzo, A, Giaquinta, AT et al. Mini-invasive treatment of a large pseudoaneurysm of the neck related to central venous catheter placement. Medicine 2018 Jul;97(29):e11262.
  • Dwivedi AJ, Cherukupalli C, Dayal R et al. Endovascular treatment of false aneurysm of the thyrocervical trunk. Vascular and Endovascular Surgery 2007;41(1):77–79.
  • Mazzei V, Benvenuto D, Gagliardi M et al. Thyrocervical trunk pseudoaneurysm following central venous catheterization. Journal of Cardiac Surgery 2011;26(6): 617–618.
  • Salviz EA, Tetik A, Demirdogen V et al. A Rare Complication of Internal Jugular Vein Cannulation: Pseudoaneurysm of the Thyrocervical Trunk. GKDA Derg 2015;21(2):116-120.
  • Hamamoto K, Nakano M, Omoto K et al. Successful endovascular treatment of iatrogenic thyrocervical trunk pseudoaneurysm with concomitant arteriovenous fistula using 0.010-inch detachable microcoils. Case Rep Vasc Med 2014;2014:479656.
  • Shield CF, Richardson JD, Buckley CJ et al. Pseudoaneurysm of the brachiocephalic arteries: a complication of percutaneous internal jugular vein catheterization. Surgery 1975;78:190-4.
  • Koroglu M, Demir M, Koroglu BK, et al. Percutaneous placement of central venous catheters: comparing the anatomical landmark method with the radiologically guided technique for central venous catheterization through the internal jugular vein in emergent hemodialysis patients. Acta Radiol 2006;43–7.
  • Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound- guided catheterization of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 2006;10:R162.
  • Bansal R, Agarwal SK, Tiwari SC, et al. A prospective randomized study to compare ultrasound-guided with nonultrasound-guided double lumen internal jugular catheter insertion as a temporary hemodialysis access. Ren Fail 2005;27:561–4.
  • Brooks AJ, Alfredson M, Pettigrew B et al. Ultrasound-guided insertion of subclavian venous access ports. Ann R Coll Surg Engl 2005;87:25-7.
  • Meyer R, Meiss L, Mali WP. Repair of a pseudoaneurysm in the neck by sonographically guided compression (letter). Am J Roentgenol 1996;166:994.

Pseudoaneurysm After Central Venous Catheterization Intervention and Endovascular Treatment

Year 2021, Volume: 4 Issue: 4, 149 - 152, 29.12.2021
https://doi.org/10.54996/anatolianjem.1004014

Abstract

Aim: In our case, the endovascular treatment of thyrocervical truncus-derived pseudoaneurysm secondary to arterial puncture during internal jugular vein (IJV) catheterization in the emergency department is described. Our aim is to discuss the diagnosis and safe treatment of this rare complication.

Case: Emergency dialysis decision was taken for a 21-year-old male patient who applied to our emergency department. Intervention from the left IJV was attempted in the emergency room to insert a temporary hemodialysis catheter. The needle was withdrawn due to pulsatile blood coming after needle insertion. The patient, who had a rapidly growing swelling in the neck despite the pressure, was referred to our radiology unit for further examination. As a result of the examinations performed in our unit, a diagnosis of pseudoaneurysm originating from the thyrocervical trunk was made. Endovascular treatment with coil embolization was completed in angiography.

Conclusion: Pseudoaneurysm should also be considered in patients who develop swelling with or without a neck murmur after IJV catheterization and should be investigated with Doppler USG. Endovascular coil embolization should be preferred as a safe and effective method in the treatment of developing pseudoaneurysm.

References

  • Siu YP, Tong MKh, Poon WL et al. Haemodialysis catheter-related right transverse cervical artery pseudoaneurysm and treatment by coil embolization. Nephrology 2005;10:37-9.
  • Cuhaci B, Khoury P, Chvala R. Transverse Cervical Artery Pseudoaneurysm: A Rare Complication of Internal Jugular Vein Cannulation. Am J Nephrol 2000;20:476-82.
  • Orak M, Üstündag M, Güloglu C et al. Factors that effect on complication development while inserting central venous catheter. Turk J Emerg Med 2006;6(2):51-55.
  • Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: internal jugular versus subclavian access a systematic review. Crit Care Med 2002;30:454-60.
  • Palermo, C, Sanfiorenzo, A, Giaquinta, AT et al. Mini-invasive treatment of a large pseudoaneurysm of the neck related to central venous catheter placement. Medicine 2018 Jul;97(29):e11262.
  • Dwivedi AJ, Cherukupalli C, Dayal R et al. Endovascular treatment of false aneurysm of the thyrocervical trunk. Vascular and Endovascular Surgery 2007;41(1):77–79.
  • Mazzei V, Benvenuto D, Gagliardi M et al. Thyrocervical trunk pseudoaneurysm following central venous catheterization. Journal of Cardiac Surgery 2011;26(6): 617–618.
  • Salviz EA, Tetik A, Demirdogen V et al. A Rare Complication of Internal Jugular Vein Cannulation: Pseudoaneurysm of the Thyrocervical Trunk. GKDA Derg 2015;21(2):116-120.
  • Hamamoto K, Nakano M, Omoto K et al. Successful endovascular treatment of iatrogenic thyrocervical trunk pseudoaneurysm with concomitant arteriovenous fistula using 0.010-inch detachable microcoils. Case Rep Vasc Med 2014;2014:479656.
  • Shield CF, Richardson JD, Buckley CJ et al. Pseudoaneurysm of the brachiocephalic arteries: a complication of percutaneous internal jugular vein catheterization. Surgery 1975;78:190-4.
  • Koroglu M, Demir M, Koroglu BK, et al. Percutaneous placement of central venous catheters: comparing the anatomical landmark method with the radiologically guided technique for central venous catheterization through the internal jugular vein in emergent hemodialysis patients. Acta Radiol 2006;43–7.
  • Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound- guided catheterization of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 2006;10:R162.
  • Bansal R, Agarwal SK, Tiwari SC, et al. A prospective randomized study to compare ultrasound-guided with nonultrasound-guided double lumen internal jugular catheter insertion as a temporary hemodialysis access. Ren Fail 2005;27:561–4.
  • Brooks AJ, Alfredson M, Pettigrew B et al. Ultrasound-guided insertion of subclavian venous access ports. Ann R Coll Surg Engl 2005;87:25-7.
  • Meyer R, Meiss L, Mali WP. Repair of a pseudoaneurysm in the neck by sonographically guided compression (letter). Am J Roentgenol 1996;166:994.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Report
Authors

Berna Keskin 0000-0003-3804-9021

Erdem Birgi 0000-0001-7808-7300

Onur Ergun 0000-0002-0495-0500

Azad Hekimoğlu 0000-0001-7853-019X

Erdi Tangobay This is me 0000-0003-1820-6413

Baki Hekimoğlu 0000-0002-1824-5853

Publication Date December 29, 2021
Published in Issue Year 2021 Volume: 4 Issue: 4

Cite

AMA Keskin B, Birgi E, Ergun O, Hekimoğlu A, Tangobay E, Hekimoğlu B. Santral Venöz Kateterizasyon Girişimi Sonrasında Gelişen Psödoanevrizma ve Endovasküler Tedavisi. Anatolian J Emerg Med. December 2021;4(4):149-152. doi:10.54996/anatolianjem.1004014