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Case Reports
Brachiocephalic Vein Perforation During Cannulation of Internal Jugular Vein: A Case Report.
- Atsushi Kainuma, Keiichi Oshima, Chiho Ota, Yu Okubo, Naoto Fukunaga, and Soon Hak Suh.
- From the Departments of *Anesthesiology and Critical Care, †Thoracic Surgery and ‡Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; and §Department of Anesthesiology, JSDF Hanshin Hospital, Kawanishi, Hyogo, Japan.
- A A Case Rep. 2017 Nov 1; 9 (9): 258-261.
AbstractWe 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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