Misinsertion of central venous catheter into the suspected vertebral vein: A case report

Title
Misinsertion of central venous catheter into the suspected vertebral vein: A case report
Author(s)
박상진양소희정성미
Keywords
etomidate; fentanyl; heparin; rocuronium; aged; anesthesia induction; angina pectoris; arterial oxygen saturation; artery catheter; Article; bleeding; blood pressure monitoring; body mass; case report; catheter complication; catheter misplacement; catheter removal; central venous catheterization; central venous pressure; coronary artery bypass graft; dyspnea; electrocardiography; head movement; heart rate; hospital discharge; human; intensive care unit; internal jugular vein; lumbar puncture needle; male; operating room; radial artery; seventh cervical vertebra; sixth cervical vertebra; subclavian vein catheterization; thorax radiography; ultrasound; vascular guide wire
Issue Date
201411
Citation
Korean Journal of Anesthesiology, v.67, no.5, pp.342 - 345
Abstract
We experienced a case in which a central venous catheter (CVC) was misplaced into the wrong vein, which was mistaken for the internal jugular vein (IJV), identified by chest x-ray and ultrasound. The vertebral vein passes through the transverse foramina from the atlas to the 6th cervical vertebra. After exiting the transverse foramen of the 6th vertebra, the vein subsequently runs anterolateral to the vertebral artery and posterior to the IJV and drains the innominate vein. In this case, chest x-ray and ultrasound revealed that the inserted CVC had a course very similar to the vertebral vein. The misplacement of a CVC into the vertebral vein might occur from excessive rotation of the patient's head, which leads to alterations in the cervical vascular anatomy, and from deep insertion of the puncture needle. Therefore, it is advised, for safe CVC insertion, to minimize a patient's head rotation and to make use of ultrasound when the anatomical structures cannot be clearly identified. ? the Korean Society of Anesthesiologists, 2014.
URI
http://hdl.handle.net/YU.REPOSITORY/30426http://dx.doi.org/10.4097/kjae.2014.67.5.342
ISSN
2005-6419
Appears in Collections:
의과대학 > 마취통증의학교실 > Articles
의과대학 > 영상의학과학교실 > Articles
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