Erroneous placement of central venous catheters in subclavian artery: Retrieval and successful hemostasis with a femoral closure device

J Vasc Access. 2022 Sep;23(5):692-697. doi: 10.1177/11297298211007704. Epub 2021 Apr 7.

Abstract

Background: Retrospective evaluation of the safety and efficacy of the retrieval of misplaced central venous catheters (CVCs) in subclavian arteries using the femoral closure device Angio-Seal™.

Methods: The clinical data of five patients (female, n = 2; mean age, 55.0 years ± 11.9) in whom a misplaced CVC within a subclavian artery was removed followed by closure of the vessel entry site with 8-French (F) Angio-Seal™ was analyzed.

Results: In 4/5 patients (80%; CVC diameter, 7-8F) the procedure was technically successful without complications. In 1/5 patients (20%; CVC diameter, 11.5F) the procedure failed and an additional covered stent was placed for successful closure of the vessel entry site. There were no complications associated with the Angio-Seal™ or stent implantation during follow-up.

Conclusion: Retrieval of a misplaced CVC within a subclavian artery using the percutaneous closure device Angio-Seal™ is quite safe and effective; however, caution is required if there is a mismatch in the diameter of the Angio-Seal™ and CVC. In the case of procedure failure, successful closure of the vessel entry site can be achieved by covered stent placement.

Keywords: Angiography; arteries; central venous catheter; percutaneous closure device; vascular interventional radiology.

MeSH terms

  • Catheterization, Central Venous* / adverse effects
  • Central Venous Catheters*
  • Female
  • Femoral Artery / diagnostic imaging
  • Hemostasis
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / surgery
  • Treatment Outcome