Inadvertent Arterial Placement of Central Venous Catheters: Systematic Review and Guidelines for Treatment

• Published in: Journal of vascular and interventional radiology Vol. 30; no. 11; pp. 1785 - 1794
• Main Authors: Dornbos, David L., Nimjee, Shahid M., Smith, Tony P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2019
• Subjects: Algorithms; Arteries - diagnostic imaging; Arteries - injuries; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - instrumentation; Central Venous Catheters; Clinical Decision-Making; Consensus; Decision Support Techniques; Equipment Design; Evidence-Based Medicine; Humans; Practice Guidelines as Topic; Risk Factors; Treatment Outcome; Vascular System Injuries - diagnostic imaging; Vascular System Injuries - etiology; Vascular System Injuries - therapy; PCD
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2019.05.017

Inadvertent arterial placement of central venous catheters carries serious sequelae, including pseudoaneurysm development and stroke. Although numerous strategies for therapeutic repair after arterial injury have been employed, no treatment provides a definitive standard of care. All articles published between January 2000 and July 2018 involving the placement of central venous catheters in the brachiocephalic or subclavian arteries, carotid artery, vertebral artery, and aortic arch and subsequent treatment were systematically reviewed. Arterial repair consisted of manual pressure, endovascular techniques (balloon tamponade, percutaneous closure devices, and covered stent placement), and open surgery. Success rates favored endovascular techniques and surgery over manual compression.