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Malposition of central venous catheter in the jugular venous arch via external jugular vein -a case report.

Ahn S, Lee JH, Park C, Hong YW, Chun DH - Korean J Anesthesiol (2015)

Bottom Line: The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes.Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications.We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

ABSTRACT
The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes. Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications. We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein.

No MeSH data available.


Schematic diagram of a jugular venous system in the neck. Superior concave end of anterior jugular vein in external jugular vein (arrowhead) and the probable position of central venous catheter (dotted line). AJV: anterior jugular vein, BV: brachiocephalic vein, CVC: central venous catheter, EJV: external jugular vein, IJV: internal jugular vein, JVA: jugular venous arch, SV: subclavian vein, SVC: superior vena cava.
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Figure 3: Schematic diagram of a jugular venous system in the neck. Superior concave end of anterior jugular vein in external jugular vein (arrowhead) and the probable position of central venous catheter (dotted line). AJV: anterior jugular vein, BV: brachiocephalic vein, CVC: central venous catheter, EJV: external jugular vein, IJV: internal jugular vein, JVA: jugular venous arch, SV: subclavian vein, SVC: superior vena cava.

Mentions: Due to the anatomical variation and complicated venous network, the malpositioning of the CVC into the JVA via EJV is not an uncommon event. But placing a catheter tip in the vessels with small diameter significantly increases the risk of thrombosis, perforation of the vessel, and extravasation of the infusate [15]. In this case, the vessel was damaged by the catheter. The loss of continuity of the vessel seemed to be due to the application of sternal retractor to spread the sternum. If it was removed without ligating the vessel, a serious complication from bleeding could have happened. Since chest X-ray or contrast was not used to confirm the exact anatomy of the vessels in this case, we can presume the horizontal and superior concave curve of the AJV in the EJV (Fig. 3). Therefore, one must always consider the possibility of misplacement of the CVC by checking the central venous wave form and obtaining chest X-ray.


Malposition of central venous catheter in the jugular venous arch via external jugular vein -a case report.

Ahn S, Lee JH, Park C, Hong YW, Chun DH - Korean J Anesthesiol (2015)

Schematic diagram of a jugular venous system in the neck. Superior concave end of anterior jugular vein in external jugular vein (arrowhead) and the probable position of central venous catheter (dotted line). AJV: anterior jugular vein, BV: brachiocephalic vein, CVC: central venous catheter, EJV: external jugular vein, IJV: internal jugular vein, JVA: jugular venous arch, SV: subclavian vein, SVC: superior vena cava.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384406&req=5

Figure 3: Schematic diagram of a jugular venous system in the neck. Superior concave end of anterior jugular vein in external jugular vein (arrowhead) and the probable position of central venous catheter (dotted line). AJV: anterior jugular vein, BV: brachiocephalic vein, CVC: central venous catheter, EJV: external jugular vein, IJV: internal jugular vein, JVA: jugular venous arch, SV: subclavian vein, SVC: superior vena cava.
Mentions: Due to the anatomical variation and complicated venous network, the malpositioning of the CVC into the JVA via EJV is not an uncommon event. But placing a catheter tip in the vessels with small diameter significantly increases the risk of thrombosis, perforation of the vessel, and extravasation of the infusate [15]. In this case, the vessel was damaged by the catheter. The loss of continuity of the vessel seemed to be due to the application of sternal retractor to spread the sternum. If it was removed without ligating the vessel, a serious complication from bleeding could have happened. Since chest X-ray or contrast was not used to confirm the exact anatomy of the vessels in this case, we can presume the horizontal and superior concave curve of the AJV in the EJV (Fig. 3). Therefore, one must always consider the possibility of misplacement of the CVC by checking the central venous wave form and obtaining chest X-ray.

Bottom Line: The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes.Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications.We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

ABSTRACT
The central venous cannulation is commonly performed in the operating rooms and intensive care units for various purposes. Although the central venous catheter (CVC) is used in many ways, the malpositioning of the CVC is often associated with serious complications. We report a case of an unexpected malposition of a CVC in the jugular venous arch via external jugular vein.

No MeSH data available.