Delayed Presentation of Catheter-related Subclavian Artery Pseudoaneurysm

Authors

  • Kim M Department of Internal Medicine,College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • ES Kang Department of Internal Medicine,College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • HW Kim Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • Y Kim The Radiology, College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • MH Kang Department of Internal Medicine,College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • YJ Chang Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • KH Choe Department of Internal Medicine,College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • KM Lee Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.
  • JY An Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheong-ju, Republic of Korea.

DOI:

https://doi.org/10.31729/jnma.2775

Keywords:

butyl 2-cyanacrylate; pseudoaneurysm; subclavian; thrombin.

Abstract

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here, we report a case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient’s symptoms began two weeks after the initial catheterization, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery.

Keywords: butyl 2-cyanacrylate; pseudoaneurysm; subclavian; thrombin.

References

David C. McGee, M.D., and Michael K. Gould, M.D.
Preventing Complications of Central Venous Catheterization.
N Engl J Med 2003;348:1123-33.
2. Schwengel DA, McGready J, Berenholtz SM, Kozlowski LJ,
Nichols DG, Yaster M. Peripherally inserted central catheters:
a randomized, controlled prospective trial in pediatric
surgical patients. Anesth Analg. 2004;99:1038-43.
3. Piffaretti G, Tozzi M, Lomazzi C, Rivolta N, Caronno R,
Laganà D et al. Endovascular treatment for traumatic injuries
of the peripheral arteries following blunt trauma. Injury. 2007
Sep;38(9):1091-7.
4. Hilary A. Brown, John E. Aruny, John A. Elefteriades, , Bauer
E. Sumpio. Subclavian Aneurysm Presenting with Massive
Hemoptysis: A Case Report and Review of the Literature Int
J Angiol 2013;22:69–74.
5. Jeganathan R1, Harkin DW, Lowry P, Lee B. Iatrogenic
subclavian artery pseudoaneurysm causing airway
compromise: treatment with percutaneous thrombin
injection. J Vasc Surg. 2004 Aug;40(2):371-4.
Young et al. Delayed Presentation of Catheter-related Subclavian Artery Pseudoaneurysm
6. Boccardo P, Remuzzi G, Galbusera M. Platelet dysfunction in
renal failure. 2004 Oct;30(5):579-89.
7. Ohki T, Veith FJ. Five-year experience with endovascular
grafts for the treatment of aneurysmal, occlusive and
traumatic arterial lesions. Cardiovasc Surg. 1998;6(6):552-65.
8. Marin ML, Hollier L, Avrahami R, Parsons R. Varying
Strategies For Endovascular Repair Of Abdominal And Iliac
Artery Aneurysms. Surg Clin North Am. 1998;78(4):631-45.
9. La Perna L, Olin JW, Goines D, Childs MB, Ouriel K.
Ultrasound-guided thrombin injection for the treatment
of postcatheterization pseudoaneurysms. Circulation.
2000;102:2391–95.
10. Bukhari HA, Saadia R, Hardy BW. Urgent endovascular
stenting of subclavian artery pseudoaneurysm caused by
seatbelt injury. Can J Surg.2007 Aug;50(4):303-4.

Downloads

Published

2015-06-30

How to Cite

M, K., Kang, E., Kim, H., Kim, Y., Kang, M., Chang, Y., Choe, K., Lee, K., & An, J. (2015). Delayed Presentation of Catheter-related Subclavian Artery Pseudoaneurysm. Journal of Nepal Medical Association, 53(198), 130–133. https://doi.org/10.31729/jnma.2775

Issue

Section

Case Reports