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2017•A & A Case ReportsOpen access

Brachiocephalic Vein Perforation During Cannulation of Internal Jugular Vein

Atsushi Kainuma, Keiichi Oshima, Chiho Ota, Yu Okubo, Naoto Fukunaga, Soon Hak Suh

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Abstract

We report a rare complication of right brachiocephalic vein perforation during ultrasound-guided cannulation of the right internal jugular vein (IJV) in a patient with a tortuous common carotid artery (CCA). We suspect that the tortuous CCA displaced the IJV, which caused misplacement of the J-tip guidewire into the subclavian vein. The stiff dilator sheath introduced over the guidewire then perforated the wall of the brachiocephalic vein, causing massive hemothorax. This was diagnosed by videothoracoscopy. Anesthesiologists should be aware of the possibility of guidewire malposition during IJV catheterization in patients with a tortuous CCA.

About this research paper

What this paper is about

We report a rare complication of right brachiocephalic vein perforation during ultrasound-guided cannulation of the right internal jugular vein (IJV) in a patient with a tortuous common carotid artery (CCA). We suspect that the tortuous CCA displaced the IJV, which caused misplacement of the J-tip guidewire into the subclavian vein. The stiff dilator sheath introduced over the guidewire then perforated the wall of the brachiocephalic vein, causing massive hemothorax. This was diagnosed by videothoracoscopy. Anesthesiologists should be aware of the possibility of guidewire malposition during IJV catheterization in patients with a tortuous CCA.

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OpenAlex reports 10 citations for this work. Citation counts describe recorded attention and do not establish research quality.

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Available abstract

We report a rare complication of right brachiocephalic vein perforation during ultrasound-guided cannulation of the right internal jugular vein (IJV) in a patient with a tortuous common carotid artery (CCA). We suspect that the tortuous CCA displaced the IJV, which caused misplacement of the J-tip guidewire into the subclavian vein. The stiff dilator sheath introduced over the guidewire then perforated the wall of the brachiocephalic vein, causing massive hemothorax. This was diagnosed by videothoracoscopy. Anesthesiologists should be aware of the possibility of guidewire malposition during IJV catheterization in patients with a tortuous CCA.

Key concepts: Medicine, Brachiocephalic vein, Internal jugular vein, Subclavian vein, Perforation, Radiology, Hemothorax, Surgery

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