Inadvertent cannulation of vertebral artery while central venous catheterization

Vela Pascual, R.C.; Pizarro Calderón, A.G.; Sánchez Barbé, G.; García Ramos, S.

doi:10.1016/j.redare.2024.01.006

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The CVC (red arrow) crosses the left IJV and accesses the left vertebral artery, with the distal end in the ascending aorta, with no other signs of complications." ] ] ] "textoCompleto" => "A 79-year-old man with a history of stage IV rectal cancer underwent emergency surgery due to intestinal obstruction and ischaemia. At the end of the surgery in the operating room, a central venous catheter (CVC) was placed for parenteral nutrition.Using ultrasound, an out-of-plane puncture of the left internal jugular vein (IJV) was performed. Entry into the vein and aspiration of blood were observed. Upon removing the syringe, non-pulsatile, dark-coloured blood flow was noted. The guidewire was then introduced through the needle without resistance. The location in the IJV was verified using ultrasound, although without tracking its entire course. The catheter was then advanced over the guidewire after dilating the tract and subsequently fixed to the skin. Extubation was performed without incidents and the patient was transferred in a stable condition to the Intensive Care Unit (ICU).Upon admission to ICU, a blood pressure curve was obtained during the measurement of central venous pressure. Suspecting an arterial cannulation, an urgent CT scan was requested (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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