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| Tan Chor Lip Henry,Tan Jih Huei,Mohamad Yuzaidi,Lenny Suryani Safri,K. Krishna,Imran Alwi Rizal,Md Idris Mohamad Azim,Hanafiah Harunarashid.[J].Chin J Traumatol,2020,23(1):29-31. [doi] |
| Unexpected complication of arteriovenous fistula of the left common carotid to internal jugular vein following central venous catheterization |
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| DOI： |
| KeyWord: ArteryCannulationArterio-venous fistulaUltrasound |
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| Author Name | Affiliation | | Tan Chor Lip Henry | Trauma Surgery Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia | | Tan Jih Huei | Trauma Surgery Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia
Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia | | Mohamad Yuzaidi | Trauma Surgery Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia | | Lenny Suryani Safri | Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia | | K. Krishna | Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia | | Imran Alwi Rizal | Trauma Surgery Unit, Department of Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia | | Md Idris Mohamad Azim | Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia | | Hanafiah Harunarashid | Vascular Surgery Unit, Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia |
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| Abstract: |
| Incidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted
in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation. |
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